WorldWideScience

Sample records for adjuvant external beam

  1. Role of adjuvant postoperative external beam radiotherapy for well differentiated thyroid cancer

    Kwon, Jeanny; Wu, Hong Gyun; Youn, Yeo Kyu; Lee, Kyu Eun; Kim, Kwang Hyun; Park, Do Joon [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2013-09-15

    To analyze the outcome of adjuvant postoperative external beam radiotherapy (EBRT) in well-differentiated thyroid cancer (WDTC). We identified 84 patients treated with EBRT for WDTC from February 1981 to December 2010. Among them, we analyzed 39 patients who received EBRT after initial radical surgery. Twenty-four females and 15 males were included. The median age was 49 years (range, 16 to 72 years). There were 34 papillary thyroid carcinomas and 5 follicular thyroid carcinomas. Most patients showed pathologic T3/T4 stage (54%/26%). Ten patients (25.6%) had gross residual tumors. Five patients (12.8%) had tumor cells at the margin. The median EBRT dose and fraction size were 62.6 Gy and 1.8 to 2.0 Gy, respectively. The median follow-up was 73 months (range, 21 to 372 months). The five-year overall survival (OS) and locoregional recurrence free survival (LRFS) were 97.4% and 86.9%, respectively. Locoregional failures occurred in 5 and all failure sites were the neck node area. In univariate analysis, OS was significantly influenced by invasion of the trachea (p = 0.016) or esophagus (p = 0.006). LRFS was significantly decreased by male (p = 0.020), gross residuum after resection (p = 0.002), close or positive tumor at surgical margin involvement (p = 0.044), and tracheal invasion (p = 0.040). No significant prognostic factor was identified in the multivariate analysis. No patient experienced the Radiation Therapy Oncology Group grade 3 or more toxicity. Our locoregional control rate of 87.2% is comparable to historical controls with surgery alone, even though our study had a large proportion of advanced stage. Adjuvant EBRT may an effective and safe treatment option in patients with WDTC.

  2. Multicenter study differentiated thyroid carcinoma (MSDS). Diminished acceptance of adjuvant external beam radiotherapy

    Biermann, M.; Pixberg, M.K.; Schober, O. [Muenster Univ. (Germany). Dept. of Nuclear Medicine; Schuck, A.; Willich, N. [Muenster Univ. (Germany). Dept. of Radiooncology; Heinecke, A.; Koepke, W. [Muenster Univ. (Germany). Dept. of Medical Informatics and Biomathematics; Schmid, K.W. [Essen Univ. (Germany). Dept. of Pathology; Dralle, H. [Halle-Wittenberg Univ., Halle (Germany). Dept. of Surgery

    2003-12-01

    Aim: The Multicenter Study Differentiated Thyroid Carcinoma (MSDS) is an ongoing study in Germany, Austria, and Switzerland on the clinical benefit of adjuvant external beam radiotherapy (RTx) for locally invasive differentiated thyroid carcinoma (DTC) in TNM stages pT4 pNO/1/xMO/x (5th ed. 1997). Methods: MSDS was designed as a prospective randomized trial. Patients receive thyroidectomy, radioiodine therapy (RIT) to ablate the thyroid remnant, and TSH-suppressive L-thyroxine therapy with or without RTx after documented elimination of cervical iodine-131 uptake (http://msds-studie.uni-muenster.de). Results: 311 patients were enrolled between January 2000 and March 2003. 279 patients met the trial's inclusion criteria. 45 consented to randomization, of whom 17 were randomized into treatment arm A (RTx) and 18 into arm B (no RTx). Advised by the trial's independent Data Monitoring and Safety Committee, the MSDS steering committee decided to terminate randomization in April 2003 and continue MSDS as a prospective cohort study. 23 of the 234 patients in the observation arm of the trial were prescribed RTx by their physicians. Thus, 14% of the trial cohort were randomized or assigned to receive RTx (intention-to-treat analysis). In contrast, at least 44% of all patients with pT4 papillary DTC in Germany in the nationwide PCES study underwent RTx in 1996 (p<0.001, {chi}{sup 2}-test). Conclusions: Acceptance of external beam RTx as a treatment modality for DTC has receded to a degree that accrual of a sufficient number of patients for a randomized trial has been impossible. Observation of the trial cohort is continued in order to assess clinical event rates with and without RTx and chronic RTx toxicity. (orig.) [German] Ziel: Die Multizentrische Studie Differenziertes Schilddruesenkarzinom (MSDS) ist eine laufende Studie in Deutschland, Oesterreich und der Schweiz zum klinischen Nutzen der adjuvanten perkutanen Strahlentherapie (RTx) bei lokal invasivem

  3. Combined brachytherapy and external beam radiotherapy without adjuvant androgen deprivation therapy for high-risk prostate cancer

    To report the outcomes of patients treated with combined iodine-125 (I-125) brachytherapy and external beam radiotherapy (EBRT) for high-risk prostate cancer. Between 2003 and 2009, I-125 permanent prostate brachytherapy plus EBRT was performed for 206 patients with high-risk prostate cancer. High-risk patients had prostate-specific antigen ≥ 20 ng/mL, and/or Gleason score ≥ 8, and/or Stage ≥ T3. One hundred and one patients (49.0%) received neoadjuvant androgen deprivation therapy (ADT) but none were given adjuvant ADT. Biochemical failure-free survival (BFFS) was determined using the Phoenix definition. The 5-year actuarial BFFS rate was 84.8%. The 5-year cause-specific survival and overall survival rates were 98.7% and 97.6%, respectively. There were 8 deaths (3.9%), of which 2 were due to prostate cancer. On multivariate analysis, positive biopsy core rates and the number of high-risk factors were independent predictors of BFFS. The 5-year BFFS rates for patients in the positive biopsy core rate <50% and ≥50% groups were 89.3% and 78.2%, respectively (p = 0.03). The 5-year BFFS rate for patients with the any single high-risk factor was 86.1%, compared with 73.6% for those with any 2 or all 3 high-risk factors (p = 0.03). Neoadjuvant ADT did not impact the 5-year BFFS. At a median follow-up of 60 months, high-risk prostate cancer patients undergoing combined I-125 brachytherapy and EBRT without adjuvant ADT have a high probability of achieving 5-year BFFS

  4. External Beam Therapy (EBT)

    ... Physician Resources Professions Site Index A-Z External Beam Therapy (EBT) External beam therapy (EBT) is a ... follow-up should I expect? What is external beam therapy and how is it used? External beam ...

  5. Impact of External Beam Adjuvant Radiotherapy on Health-Related Quality of Life for Long-Term Survivors of Endometrial Adenocarcinoma: A Population-Based Study

    Purpose: To compare the health-related quality of life (HRQOL) among 5-10-year survivors of Stage I-II endometrial (adeno-)carcinoma (EC) treated with surgery alone or surgery with external beam adjuvant radiotherapy (EBRT) and an age-matched norm population. Methods and Materials: A population-based, cross-sectional survey was conducted by the Eindhoven Cancer Registry. All patients were included who had been diagnosed with EC between 1994 and 1998 (n = 462). Information from the questionnaires returned was linked to data from the Eindhoven Cancer Registry on patient, tumor, and treatment characteristics. Results: Responses were received from 75% of the patients. The analyses were restricted to women with Stage I-II disease at diagnosis, treated with either surgery alone or surgery with adjuvant EBRT, and without recurrent disease or new primary malignancies (n = 264). The patients who had received adjuvant EBRT (n = 80) had had a significantly higher tumor stage and grade at diagnosis (p < 0.0001) and a longer mean time since diagnosis (p = 0.04). Age, number of comorbid diseases, current marital status, nulliparity, education, and occupation were similar for both treatment groups. On multivariate analyses, adjuvant EBRT was independently and negatively associated with the vitality and physical and social well-being scale scores. The HRQOL scores of both treatment groups, however, were similar to those of an age-matched norm population. Conclusion: In general, the HRQOL of EC survivors is good. EC survivors treated with surgery alone had a better HRQOL than women treated with surgery and adjuvant EBRT, although for both groups, the HRQOL was in the range of the norm population

  6. Impact of Adjuvant External-Beam Radiation Therapy in Early-Stage Uterine Papillary Serous and Clear Cell Carcinoma

    Purpose: Adjuvant radiation therapy (RT) in early-stage high- to intermediate-risk endometrioid adenocarcinoma is well established and has been shown to improve locoregional control. Its role in the management of early-stage clear cell carcinoma and uterine papillary serous carcinoma (UPSC) remains controversial. Methods and Materials: Using the Surveillance Epidemiology and End Results database, we identified women with American Joint Committee on Cancer Stage Sixth Edition. Stage IA–IIB clear cell carcinoma or UPSC who underwent hysterectomy with or without adjuvant RT between 1988 and 2003. We used Kaplan-Meier and Cox regression analysis to compare overall survival (OS) for all patients. Results: We identified 1,333 women of whom 451 had clear cell carcinoma and 882 had UPSC. Of those patients, 775 underwent surgery alone and 558 received adjuvant RT as well. For Stages I–IIB disease, the median OS with surgery alone was 106 months, vs. 151 months with adjuvant RT (p = 0.006). On subgroup analysis, we saw the benefit from adjuvant RT only in Stage IB–C patients. For Stage IB disease, patients undergoing surgery alone had a median OS of 117 months, vs. median survival not reached with the addition of RT (p = 0.006). For Stage IC disease, surgery alone had a median OS of 35 months vs. 120 months with RT (p = 0.001). Although the apparent benefit of RT diminished when measured via multivariate analysis, the impact of RT on survival did show a trend toward significance (hazard ration 0.808, confidence interval 95% 0.651–1.002, p = 0.052) Conclusion: In FIGO Stage IB–C papillary serous and clear cell uterine carcinoma, adjuvant RT seems to play an important role in improving survival.

  7. Impact of Adjuvant External-Beam Radiation Therapy in Early-Stage Uterine Papillary Serous and Clear Cell Carcinoma

    Kim, Anne, E-mail: akim2@health-quest.org [Department of Radiation Oncology, Vassar Brothers Medical Center, Poughkeepsie, NY (United States); Schreiber, David [Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, NY (United States); Rineer, Justin [Department of Radiation Oncology, MD Anderson Cancer Center Orlando, Orlando, FL (United States); Choi, Kwang; Rotman, Marvin [Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY (United States)

    2011-11-15

    Purpose: Adjuvant radiation therapy (RT) in early-stage high- to intermediate-risk endometrioid adenocarcinoma is well established and has been shown to improve locoregional control. Its role in the management of early-stage clear cell carcinoma and uterine papillary serous carcinoma (UPSC) remains controversial. Methods and Materials: Using the Surveillance Epidemiology and End Results database, we identified women with American Joint Committee on Cancer Stage Sixth Edition. Stage IA-IIB clear cell carcinoma or UPSC who underwent hysterectomy with or without adjuvant RT between 1988 and 2003. We used Kaplan-Meier and Cox regression analysis to compare overall survival (OS) for all patients. Results: We identified 1,333 women of whom 451 had clear cell carcinoma and 882 had UPSC. Of those patients, 775 underwent surgery alone and 558 received adjuvant RT as well. For Stages I-IIB disease, the median OS with surgery alone was 106 months, vs. 151 months with adjuvant RT (p = 0.006). On subgroup analysis, we saw the benefit from adjuvant RT only in Stage IB-C patients. For Stage IB disease, patients undergoing surgery alone had a median OS of 117 months, vs. median survival not reached with the addition of RT (p = 0.006). For Stage IC disease, surgery alone had a median OS of 35 months vs. 120 months with RT (p = 0.001). Although the apparent benefit of RT diminished when measured via multivariate analysis, the impact of RT on survival did show a trend toward significance (hazard ration 0.808, confidence interval 95% 0.651-1.002, p = 0.052) Conclusion: In FIGO Stage IB-C papillary serous and clear cell uterine carcinoma, adjuvant RT seems to play an important role in improving survival.

  8. Benefit of Adjuvant Brachytherapy Versus External Beam Radiation for Early Breast Cancer: Impact of Patient Stratification on Breast Preservation

    Smith, Grace L. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Jiang, Jing [Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Buchholz, Thomas A. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Xu, Ying [Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hoffman, Karen E. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Giordano, Sharon H. [Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hunt, Kelly K. [Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Smith, Benjamin D., E-mail: bsmith3@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2014-02-01

    Purpose: Brachytherapy after lumpectomy is an increasingly popular breast cancer treatment, but data concerning its effectiveness are conflicting. Recently proposed “suitability” criteria guiding patient selection for brachytherapy have never been empirically validated. Methods: Using the Surveillance, Epidemiology, and End Results–Medicare linked database, we compared women aged 66 years or older with invasive breast cancer (n=28,718) or ductal carcinoma in situ (n=7229) diagnosed from 2002 to 2007, treated with lumpectomy alone, brachytherapy, or external beam radiation therapy (EBRT). The likelihood of breast preservation, measured by subsequent mastectomy risk, was compared by use of multivariate proportional hazards, further stratified by American Society for Radiation Oncology (ASTRO) brachytherapy suitability groups. We compared 1-year postoperative complications using the χ{sup 2} test and 5-year local toxicities using the log-rank test. Results: For patients with invasive cancer, the 5-year subsequent mastectomy risk was 4.7% after lumpectomy alone (95% confidence interval [CI], 4.1%-5.4%), 2.8% after brachytherapy (95% CI, 1.8%-4.3%), and 1.3% after EBRT (95% CI, 1.1%-1.5%) (P<.001). Compared with lumpectomy alone, brachytherapy achieved a more modest reduction in adjusted risk (hazard ratio [HR], 0.61; 95% CI, 0.40-0.94) than achieved with EBRT (HR, 0.22; 95% CI, 0.18-0.28). Relative risks did not differ when stratified by ASTRO suitability group (P=.84 for interaction), although ASTRO “suitable” patients did show a low absolute subsequent mastectomy risk, with a minimal absolute difference in risk after brachytherapy (1.6%; 95% CI, 0.7%-3.5%) versus EBRT (0.8%; 95% CI, 0.6%-1.1%). For patients with ductal carcinoma in situ, EBRT maintained a reduced risk of subsequent mastectomy (HR, 0.40; 95% CI, 0.28-0.55; P<.001), whereas the small number of patients treated with brachytherapy (n=179) precluded definitive comparison with lumpectomy alone

  9. Benefit of Adjuvant Brachytherapy Versus External Beam Radiation for Early Breast Cancer: Impact of Patient Stratification on Breast Preservation

    Purpose: Brachytherapy after lumpectomy is an increasingly popular breast cancer treatment, but data concerning its effectiveness are conflicting. Recently proposed “suitability” criteria guiding patient selection for brachytherapy have never been empirically validated. Methods: Using the Surveillance, Epidemiology, and End Results–Medicare linked database, we compared women aged 66 years or older with invasive breast cancer (n=28,718) or ductal carcinoma in situ (n=7229) diagnosed from 2002 to 2007, treated with lumpectomy alone, brachytherapy, or external beam radiation therapy (EBRT). The likelihood of breast preservation, measured by subsequent mastectomy risk, was compared by use of multivariate proportional hazards, further stratified by American Society for Radiation Oncology (ASTRO) brachytherapy suitability groups. We compared 1-year postoperative complications using the χ2 test and 5-year local toxicities using the log-rank test. Results: For patients with invasive cancer, the 5-year subsequent mastectomy risk was 4.7% after lumpectomy alone (95% confidence interval [CI], 4.1%-5.4%), 2.8% after brachytherapy (95% CI, 1.8%-4.3%), and 1.3% after EBRT (95% CI, 1.1%-1.5%) (P<.001). Compared with lumpectomy alone, brachytherapy achieved a more modest reduction in adjusted risk (hazard ratio [HR], 0.61; 95% CI, 0.40-0.94) than achieved with EBRT (HR, 0.22; 95% CI, 0.18-0.28). Relative risks did not differ when stratified by ASTRO suitability group (P=.84 for interaction), although ASTRO “suitable” patients did show a low absolute subsequent mastectomy risk, with a minimal absolute difference in risk after brachytherapy (1.6%; 95% CI, 0.7%-3.5%) versus EBRT (0.8%; 95% CI, 0.6%-1.1%). For patients with ductal carcinoma in situ, EBRT maintained a reduced risk of subsequent mastectomy (HR, 0.40; 95% CI, 0.28-0.55; P<.001), whereas the small number of patients treated with brachytherapy (n=179) precluded definitive comparison with lumpectomy alone. In all

  10. Clinical outcomes of adjuvant external-beam radiotherapy for differentiated thyroid cancer. Results after 874 patient-years of follow-up in the MSDS-trial

    Biermann, M. [Haukeland University Hospital, Bergen (Norway). Dept. of Radiology; Pixberg, M.K.; Riemann, B.; Schober, O. [Muenster Univ. (Germany). Dept. of Nuclear Medicine; Schuck, A.; Willich, N. [Muenster Univ. (Germany). Dept. of Radiooncology; Heinecke, A. [Muenster Univ. (Germany). Dept. of Biometrics; Schmid, K.W. [University Hospital of Essen, West German Cancer Center (Germany). Inst. of Pathology and Neuropathology; Dralle, H. [Halle-Wittenberg Univ. (Germany). Dept. of General Surgery

    2009-07-01

    Evaluate the clinical benefit of external beam radiotherapy (RTx) for locally invasive thyroid carcinoma with follicular cell differentiation (DTC). The Multicentre Study on Differentiated Thyroid Cancer (MSDS) was planned as a prospective multicenter trial on the benefit of adjuvant RTx in locally invasive DTC (pT4; UICC 1997) with or without lymph node metastases and no known distant metastases. All patients were treated with thyroidectomy, {sup 131}I-therapy, and TSH-suppression and were randomized to receive additional RTx or not. In 4/2003 the trial became a prospective cohort study after only 45 of then 311 patients had consented to randomization. 351 of 422 patients met the trial's inclusion criteria. Age was 48 {+-} 12 years (mean {+-} SD). 25% were men. Tumours were papillary in 90% and follicular in 10%. Of 47 patients randomized or allocated to RTx, 26 actually received RTx. Mean follow-up was 930 days. In an actual treatment analysis, 96% (25/26) of the RTx-patients reached complete remission (CR) vs. 86% in the non-RTx patients. Recurrences occurred in 0 vs. 3 % of patients: 6 reoperated for regional lymph node metastases, 1 tracheal invasion treated with tracheoplasty, 1 local invasion necessitating laryngectomy, 2 distant metastases (1 lung, 1 lung + bone). Serious chronic RTx toxicity occurred in 1/26 patients. The MSDS trial showed low mortality and recurrence rates and a weak benefit of RTx in terms of local control that did however not reach statistical significance. Routine RTx in locally invasive DTC can no longer be recommended. (orig.)

  11. Trends in the Utilization of Adjuvant Vaginal Cuff Brachytherapy and/or External Beam Radiation Treatment in Stage I and II Endometrial Cancer: A Surveillance, Epidemiology, and End-Results Study

    Purpose: The optimal adjuvant radiation treatment for endometrial carcinoma (EC) remains controversial. Adjuvant vaginal cuff brachytherapy (VB) has emerged as an increasingly common treatment modality. However, the time trends for using VB, external beam radiation therapy (EBRT), or combined therapy (VB+EBRT) have not been well characterized. We therefore examined the utilization trends of VB, EBRT, and VB+EBRT for adjuvant RT in International Federation of Gynecologic Oncology (FIGO) stage I and II EC over time. Methods and Materials: We evaluated treatment patterns for 48,122 patients with EC diagnosed between January 1995 and December 2005, using the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) public use database. Chi-squared tests were used to assess differences by radiation type (VB, EBRT, and VB+EBRT) and various demographic and clinical variables. Results: Analyses were limited to 9,815 patients (20.4%) with EC who met the inclusion criteria. Among women who received adjuvant RT, the proportion receiving VB increased yearly (12.9% in 1995 compared to 32.8% in 2005 (p < 0.0001). The increasing use of VB was proportional to the decreasing use of EBRT (56.1% in 1995 to 45.8% in 2005; p < 0.0001) and VB+EBRT (31.0% in 1995 to 21.4% in 2005; p < 0.001). Conclusions: This population-based report demonstrates an increasing trend in the use of VB in the adjuvant setting after hysterectomy for treatment of women with FIGO stage I II EC. VB alone appears to be replacing pelvic EBRT and VB+EBRT therapy in the management of stage I–II EC.

  12. Trends in the Utilization of Adjuvant Vaginal Cuff Brachytherapy and/or External Beam Radiation Treatment in Stage I and II Endometrial Cancer: A Surveillance, Epidemiology, and End-Results Study

    Patel, Mehul K. [Department of Radiation Oncology, Henry Ford Health System, Detroit, Michigan (United States); Cote, Michele L. [Karmanos Cancer Institute and Wayne State University, Detroit, Michigan (United States); Ali-Fehmi, Rouba [Department of Pathology, Wayne State University School of Medicine, Detroit, Michigan (United States); Buekers, Thomas; Munkarah, Adnan R. [Department of Women' s Health Services, Division of Gynecologic Oncology, Henry Ford Health System, Detroit, Michigan (United States); Elshaikh, Mohamed A., E-mail: melshai1@hfhs.org [Department of Radiation Oncology, Henry Ford Health System, Detroit, Michigan (United States)

    2012-05-01

    Purpose: The optimal adjuvant radiation treatment for endometrial carcinoma (EC) remains controversial. Adjuvant vaginal cuff brachytherapy (VB) has emerged as an increasingly common treatment modality. However, the time trends for using VB, external beam radiation therapy (EBRT), or combined therapy (VB+EBRT) have not been well characterized. We therefore examined the utilization trends of VB, EBRT, and VB+EBRT for adjuvant RT in International Federation of Gynecologic Oncology (FIGO) stage I and II EC over time. Methods and Materials: We evaluated treatment patterns for 48,122 patients with EC diagnosed between January 1995 and December 2005, using the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) public use database. Chi-squared tests were used to assess differences by radiation type (VB, EBRT, and VB+EBRT) and various demographic and clinical variables. Results: Analyses were limited to 9,815 patients (20.4%) with EC who met the inclusion criteria. Among women who received adjuvant RT, the proportion receiving VB increased yearly (12.9% in 1995 compared to 32.8% in 2005 (p < 0.0001). The increasing use of VB was proportional to the decreasing use of EBRT (56.1% in 1995 to 45.8% in 2005; p < 0.0001) and VB+EBRT (31.0% in 1995 to 21.4% in 2005; p < 0.001). Conclusions: This population-based report demonstrates an increasing trend in the use of VB in the adjuvant setting after hysterectomy for treatment of women with FIGO stage I-II EC. VB alone appears to be replacing pelvic EBRT and VB+EBRT therapy in the management of stage I-II EC.

  13. Combination of External Beam Radiotherapy (EBRT) With Intratumoral Injection of Dendritic Cells as Neo-Adjuvant Treatment of High-Risk Soft Tissue Sarcoma Patients

    Finkelstein, Steven E., E-mail: steven.finkelstein@moffitt.org [H. Lee Moffitt Cancer Center, Tampa, FL (United States); Iclozan, Cristina; Bui, Marilyn M.; Cotter, Matthew J.; Ramakrishnan, Rupal; Ahmed, Jamil; Noyes, David R.; Cheong, David; Gonzalez, Ricardo J.; Heysek, Randy V.; Berman, Claudia; Lenox, Brianna C.; Janssen, William; Zager, Jonathan S.; Sondak, Vernon K.; Letson, G. Douglas; Antonia, Scott J. [H. Lee Moffitt Cancer Center, Tampa, FL (United States); Gabrilovich, Dmitry I., E-mail: dmitry.gabrilovich@moffitt.org [H. Lee Moffitt Cancer Center, Tampa, FL (United States)

    2012-02-01

    Purpose: The goal of this study was to determine the effect of combination of intratumoral administration of dendritic cells (DC) and fractionated external beam radiation (EBRT) on tumor-specific immune responses in patients with soft-tissue sarcoma (STS). Methods and Material: Seventeen patients with large (>5 cm) high-grade STS were enrolled in the study. They were treated in the neoadjuvant setting with 5,040 cGy of EBRT, split into 28 fractions and delivered 5 days per week, combined with intratumoral injection of 10{sup 7} DCs followed by complete resection. DCs were injected on the second, third, and fourth Friday of the treatment cycle. Clinical evaluation and immunological assessments were performed. Results: The treatment was well tolerated. No patient had tumor-specific immune responses before combined EBRT/DC therapy; 9 patients (52.9%) developed tumor-specific immune responses, which lasted from 11 to 42 weeks. Twelve of 17 patients (70.6%) were progression free after 1 year. Treatment caused a dramatic accumulation of T cells in the tumor. The presence of CD4{sup +} T cells in the tumor positively correlated with tumor-specific immune responses that developed following combined therapy. Accumulation of myeloid-derived suppressor cells but not regulatory T cells negatively correlated with the development of tumor-specific immune responses. Experiments with {sup 111}In labeled DCs demonstrated that these antigen presenting cells need at least 48 h to start migrating from tumor site. Conclusions: Combination of intratumoral DC administration with EBRT was safe and resulted in induction of antitumor immune responses. This suggests that this therapy is promising and needs further testing in clinical trials design to assess clinical efficacy.

  14. Combination of External Beam Radiotherapy (EBRT) With Intratumoral Injection of Dendritic Cells as Neo-Adjuvant Treatment of High-Risk Soft Tissue Sarcoma Patients

    Purpose: The goal of this study was to determine the effect of combination of intratumoral administration of dendritic cells (DC) and fractionated external beam radiation (EBRT) on tumor-specific immune responses in patients with soft-tissue sarcoma (STS). Methods and Material: Seventeen patients with large (>5 cm) high-grade STS were enrolled in the study. They were treated in the neoadjuvant setting with 5,040 cGy of EBRT, split into 28 fractions and delivered 5 days per week, combined with intratumoral injection of 107 DCs followed by complete resection. DCs were injected on the second, third, and fourth Friday of the treatment cycle. Clinical evaluation and immunological assessments were performed. Results: The treatment was well tolerated. No patient had tumor-specific immune responses before combined EBRT/DC therapy; 9 patients (52.9%) developed tumor-specific immune responses, which lasted from 11 to 42 weeks. Twelve of 17 patients (70.6%) were progression free after 1 year. Treatment caused a dramatic accumulation of T cells in the tumor. The presence of CD4+ T cells in the tumor positively correlated with tumor-specific immune responses that developed following combined therapy. Accumulation of myeloid-derived suppressor cells but not regulatory T cells negatively correlated with the development of tumor-specific immune responses. Experiments with 111In labeled DCs demonstrated that these antigen presenting cells need at least 48 h to start migrating from tumor site. Conclusions: Combination of intratumoral DC administration with EBRT was safe and resulted in induction of antitumor immune responses. This suggests that this therapy is promising and needs further testing in clinical trials design to assess clinical efficacy.

  15. External photon beams: Physical aspects

    Radiotherapy procedures fall into two main categories: external beam radiotherapy and brachytherapy. In external beam radiotherapy the radiation source is at a certain distance from the patient and the target within the patient is irradiated with an external radiation beam. In brachytherapy (see Chapter 13) radiation sources are placed directly into the target volume (intracavitary or interstitial brachytherapy) or on to a target (surface mould or intraoperative radiotherapy). Most external beam radiotherapy is carried out with photon beams, some with electron beams and a very small fraction with more exotic particles such as protons, heavier ions or neutrons. This chapter deals with external photon beam radiotherapy. Photon external beams are all characterized by the same physical parameters, but fall into various categories depending on their origin, means of production and energy. There are two origins of photon beams: g rays, which originate from radioactive nuclei, and X rays, which originate in a target bombarded with energetic electrons. The X rays from a target consist of bremsstrahlung photons and characteristic photons. X rays are produced either in an X ray tube (superficial or orthovoltage X rays) or in a linac (megavoltage X rays)

  16. External proton and Li beams

    In the frame of a feasibility study to introduce proton therapy in Argentina in a collaborative agreement between the Physics and Radiobiology Departments of the National Atomic Energy Commission or Argentina and the Centre de Protontherapie de Orsay, France, external proton and Li beams were produced at the TANDAR accelerator in Buenos Aires. The specific aim of this work was to start radiobiology studies on cell cultures and small laboratory animals. In particular we seek to determine here the relative biological effectiveness, RBE, for proton and Li beams as a function of energy for different tumor and normal cell lines. The 24 MeV proton beam was diffused using a 25 μm gold foil and extracted through a Kapton window to obtain a homogeneous field (constant to 95%) of about 7 cm in diameter. Measurements were carried out with quasi-monoenergetic beams (of 20.2 ± 0.07 MeV, 2.9 ± 0.10 MeV y 1.5 ± 0.1 MeV for protons and 21.4 ± 0.4 MeV for Lithium). Proton fluence and Bragg peaks were measured. The dose delivered in each case was monitored on-line with a calibrated transmission ionization chamber. Three cell lines PDV, PDVC 57 and V 79 (as a reference) were irradiated with γ-rays, proton and lithium beams with linear energy transfer (LET) from 2 to 100 keV/μm. RBE values in the range of 1.2-5.9 were obtained. In addition preliminary studies on chromosomal aberrations and viability of alveolar macrophages were carried out. (author)

  17. External Beam Radiation in Differentiated Thyroid Carcinoma

    Salem Billan

    2016-01-01

    Full Text Available The treatment of differentiated thyroid carcinoma (DTC is surgery followed in some cases by adjuvant treatment, mostly with radioactive iodine (RAI. External beam radiotherapy (EBRT is less common and not a well-established treatment modality in DTC. The risk of recurrence depends on three major prognostic factors: extra-thyroid extension, patient’s age, and tumor with reduced iodine uptake. Increased risk for recurrence is a major factor in the decision whether to treat the patient with EBRT. Data about the use of EBRT in DTC are limited to small retrospective studies. Most series have demonstrated an increase in loco-regional control. The risk/benefit from giving EBRT requires careful patient selection. Different scoring systems have been proposed by different investigators and centers. The authors encourage clinicians treating DTC to become familiarized with those scoring systems and to use them in the management of different cases. The irradiated volume should include areas of risk for microscopic disease. Determining those areas in each case can be difficult and requires detailed knowledge of the surgery and pathological results, and also understanding of the disease-spreading pattern. Treatment with EBRT in DTC can be beneficial, and data support the use of EBRT in high-risk patients. Randomized controlled trials are needed for better confirmation of the role of EBRT.

  18. The effect of short term neo-adjuvant androgen deprivation on erectile function in patients treated with external beam radiotherapy for localised prostate cancer: an analysis of the 4- versus 8-month randomised trial (Irish Clinical Oncology Research Group 97-01).

    Daly, Patricia E

    2012-07-01

    Erectile dysfunction is a common consequence of external beam radiotherapy (EBRT) for prostate cancer. The addition of neo-adjuvant androgen deprivation (NAD) has an indeterminate additive effect. We examined the long-term effect on erectile function (EF) of two durations (4 months: arm 1 and 8 months: arm 2) of NAD prior to radiation (RT) for patients with localised prostate cancer from the Irish Clinical Oncology Research Group (ICORG 97-01) 4- versus 8-month trial. In this study we aimed to (1) analyse the overall effect on EF of NAD in an EBRT population, (2) compare the probability of retained EF over time in an EBRT population treated with either 4 or 8 months of NAD and (3) identify any variables such as risk group and age which may have an additive detrimental effect. This analysis provides unique long term follow up data.

  19. Postoperative external beam radiotherapy for medulloblastoma

    Chun, Ha Chung; Lee, Myung Za [College of Medicine, Hanyang Univ., Seoul (Korea, Republic of)

    2000-06-01

    This study was performed to evaluate the effectiveness and tolerance of craniospinal irradiation for patients with medulloblastoma and to define the optimal radiotherapeutic regimen. We retrospectively analyzed the records of 43 patients with medulloblastoma who were treated with external beam craniospinal radiotherapy at our institution between May, 1984 and April, 1998. Median follow up period was 47 months with range of 18 to 86 months. Twenty seven patients were male and sixteen patients were female, a male to female ratio of 1.7:1. Surgery consisted of biopsy alone in 5 patients, subtotal excision in 24 patients, and gross total excision in 14 patients. All of the patients were treated with craniospinal irradiation. All of the patients except four received fat least 5,000 cGy to the posterior fossa and forty patients received more than 3,000 cGy to the spinal cord. The overall survival rates at 5 and 7 years for entire group of patients were 67% and 56%, respectively. Corresponding disease free survival rates were 60% and 51%, respectively. The rates of disease control in the posterior fossa were 77% and 67% at 5 and 7 years. Gross total excision and subtotal excision resulted in 5 year overall survival rates of 76% and 66%, respectively. in contrast, those patients who had biopsy alone had a 5 year survival rate of only 40%. Posterior fossa was a component of failure in 11 of the 18 recurrences. Seven recurrences were isolated to the posterior fossa. Four patients had neuraxis recurrences, three had distant metastasis alone and four had multiple sites of failure, all involving the primary site. Craniospinal irradiation for patients with medulloblastoma is an effective adjuvant treatment without significant treatment related toxicities. There is room for improvement in terms of posterior fossa control, especially in biopsy alone patients. The advances in radiotherapy including hyperfractionation, stereotactic radiosurgery and 3D conformal radiotherapy would be

  20. External beam radiation therapy for prostate cancer

    Purpose/Objectives: The intent of this course is to review the issues involved in the management of non-metastatic adenocarcinoma of the prostate. -- The value of pre-treatment prognostic factors including stage, grade and PSA value will be presented, and their value in determining therapeutic strategies will be discussed. -- Controversies involving the simulation process and treatment design will be presented. The value of CT scanning, Beams-Eye View, 3-D planning, intravesicle, intraurethral and rectal contrast will be presented. The significance of prostate and patient movement and strategies for dealing with them will be presented. -- The management of low stage, low to intermediate grade prostate cancer will be discussed. The dose, volume and timing of irradiation will be discussed as will the role of neo-adjuvant hormonal therapy, neutron irradiation and brachytherapy. The current status of radical prostatectomy and cryotherapy will be summarized. Treatment of locally advanced, poorly differentiated prostate cancer will be presented including a discussion of neo-adjuvant and adjuvant hormones, dose-escalation and neutron irradiation. -- Strategies for post-radiation failures will be presented including data on cryotherapy, salvage prostatectomy and hormonal therapy (immediate, delayed and/or intermittent). New areas for investigation will be reviewed. -- The management of patients post prostatectomy will be reviewed. Data on adjuvant radiation and therapeutic radiation for biochemical or clinically relapsed patients will be presented. This course hopes to present a realistic and pragmatic overview for treating patients with non-metastatic prostatic cancer

  1. Beam-beam effects under the influence of external noise

    Ohmi, K.

    2014-01-01

    Fast external noise, which gives fluctuation into the beam orbit, is discussed in connection with beam-beam effects. Phase noise from crab cavities and detection devices (position monitor) and kicker noise from the bunch by bunch feedback system are the sources. Beam-beam collisions with fast orbit fluctuations with turn by turn or multi-turn correlations, cause emittance growth and luminosity degradation. We discuss the tolerance of the noise amplitude for LHC and HL-LHC.

  2. Future research program for microprobe external beam

    The modification of the existing microprobe external beam system for advanced biological experiments have been presented. The model for single ion irradiation has been shown. The model of external measurement chamber and the chamber for testing the outlet windows have been also performed

  3. Beam intensity monitoring for the external proton beam at LAMPF

    Three different intensity monitors were tested in the external proton beam at LAMPF, and together cover the entire range of beam currents available. A 800 kg Faraday cup was installed and used to measure the absolute intensity to better than 1 percent for beam currents up to several nanoamperes. A high gain ion chamber was used as part of the calibration procedure for the Faraday cup, and was found to be useful when monitoring very small beam intensities, being reliable down to the few picoampere level. A secondary emission monitor was also tested, calibrated, and found to be trustworthy only for beams of greater than 50 pA intensity. (auth)

  4. New AGS slow external beam switchyard

    The original switchyard for the Slow External Proton Beam at the AGS of Brookhaven National Laboratory incorporated two current carrying, copper septa to split the beam into three parts. These septa were each .05 mm thick and intercepted a substantial amount of beam when, as often occurs, it was necessary to split the beam across its densest region. To adjust splitting ratios and optimize losses, a complex time consuming pattern of steering adjustments using various magnets was necessary. When the question of providing a fourth beam to a new target station arose, it was clear that adding a third copper septum in the very constrained space available would lead to unacceptable increases in the radiation and control problems. In order to circumvent these difficulties, it was decided to rebuild the switchyard using much thinner electrostatic septa as splitters and to provide a greater degree of independence of the various beam segments

  5. Prostate-specific antigen (Pasa) bounce and other fluctuations: Which biochemical relapse definition is least prone to PSA false calls? An analysis of 2030 men treated for prostate cancer with external beam or brachytherapy with or without adjuvant androgen deprivation therapy

    Purpose: To determine the false call (FC) rate for prostate-specific antigen (PSA) relapse according to nine different PSA relapse definitions after a PSA fluctuation (bounce) has occurred after external beam radiation therapy (EBRT) or brachytherapy, with or without adjuvant androgen deprivation therapy. Methods and Materials: An analysis of a prospective database of 2030 patients was conducted. Prostate-specific antigen relapse was scored according to the American Society for Therapeutic Radiology and Oncology (ASTRO), Vancouver, threshold + n, and nadir + n definitions for the complete data set and then compared against a truncated data set, with data subsequent to the height of the bounce deleted. The FC rate was calculated for each definition. Results: The bounce rate, with this very liberal definition of bounce, was 58% with EBRT and 84% with brachytherapy. The FC rate was lowest with nadir + 2 and + 3 definitions (2.2% and 1.6%, respectively) and greatest with low-threshold and ASTRO definitions (32% and 18%, respectively). The ASTRO definition was particularly susceptible to FC when androgen deprivation therapy was used with radiation (24%). Discussion: New definitions of biochemical non-evidence of disease that are more robust than the ASTRO definition have been identified. Those with the least FC rates are the nadir + 2 and nadir + 3 definitions, both of which are being considered to replace the ASTRO definition by the 2005 meeting of the Radiation Therapy Oncology Group-ASTRO consensus panel

  6. Results of a randomized Phase-3 trial to evaluate the efficacy of strontium-89 adjuvant to local field external beam irradiation in the management of endocrine resistant metastatic prostate cancer

    A large proportion of the practice of radiotherapy in the management of metastatic adenocarcinoma of the prostate is associated with palliation of pain from osseous metastases and improving quality of life. Strontium-89 is a systemic radionuclide that has clinical efficacy in the palliation of pain from bony metastases. The study was a Phase-3 randomized placebo control trial performed in eight Canadian Cancer Centers to evaluate the effectiveness of strontium-89 as an adjunct to local field radiotherapy. Patients with endocrine refractory metastatic prostate cancer received local field radiotherapy and either strontium-89 as a single injection of 10.8 mCi or placebo. One hundred twenty-six patients were recruited. No significant differences in survival or in relief of pain at the index site were noted. Intake of analgesics over time demonstrated a significant reduction in the arm treated with strontium-89. Progression of pain as measured by sites of new pain or the requirement for radiotherapy showed statistically significant differences between the arms in favor of strontium-89. Tumor markers including prostate specific antigen, acid phosphatase, and alkaline phosphatase were also reduced in patients receiving strontium-89. A Quality-of-Life analysis was performed as a multivariate data set and demonstrated an overall superiority of strontium-89 with alleviation of pain and improvement in physical activity being statistically significant. Toxicity was evaluated and demonstrated increased hematological toxicity in the group receiving strontium-89. It is concluded that the addition of strontium-89 is an effective adjuvant therapy to local field radiotherapy reducing progression of disease as evidenced by new sites of pain and the requirement of further radiotherapy and improving quality-of-life and need for analgesic support in this group of patients. 24 refs., 7 figs., 2 tabs

  7. The effect of short term neo-adjuvant androgen deprivation on erectile function in patients treated with external beam radiotherapy for localised prostate cancer: An analysis of the 4- versus 8-month randomised trial (Irish Clinical Oncology Research Group 97-01)

    Background and purpose: Erectile dysfunction is a common consequence of external beam radiotherapy (EBRT) for prostate cancer. The addition of neo-adjuvant androgen deprivation (NAD) has an indeterminate additive effect. We examined the long-term effect on erectile function (EF) of two durations (4 months: arm 1 and 8 months: arm 2) of NAD prior to radiation (RT) for patients with localised prostate cancer from the Irish Clinical Oncology Research Group (ICORG 97-01) 4- versus 8-month trial. In this study we aimed to (1) analyse the overall effect on EF of NAD in an EBRT population, (2) compare the probability of retained EF over time in an EBRT population treated with either 4 or 8 months of NAD and (3) identify any variables such as risk group and age which may have an additive detrimental effect. This analysis provides unique long term follow up data. Materials and methods: From 1997 to 2001, 276 patients with adenocarcinoma of the prostate were randomised to 4 or 8 months of NAD before RT. EF data were recorded at baseline and at each follow-up visit by physician directed questions, using a 4-point grading system. Results: Two hundred and thirty patients were included in the analysis of EF and were followed for a median of 80 months. One hundred and forty-one patients had EF at baseline. Neo-adjuvant androgen deprivation in addition to radiation therapy caused a significant reduction in EF. The most significant reduction in EF happens within the first year. The median time to grade 3–4 EF toxicity was 14.6 months, 17.6 months in arm 1 and 13.7 in arm 2. Freedom from late EF toxicity did not differ significantly between arms, overall or at 5 years (n = 141). The cumulative probability of EF preservation at 5 years was 28% (22–34) in arm 1 and 24% (19–30) in arm 2. Age was a significant predictor of post-treatment EF. Conclusions: The first year post ADT and EBRT poses the greatest risk to sexual function and a continued decline may be expected. However, 26

  8. Proton external beam in the TANDAR Accelerator

    An external proton beam has been obtained in the TANDAR accelerator with radiological and biomedical purposes. The protons have excellent physical properties for their use in radiotherapy allowing a very good accuracy in the dose spatial distribution inside the tissue so in the side direction as in depth owing to the presence of Bragg curve. The advantage of the accuracy in the dose localization with proton therapy is good documented (M. Wagner, Med. Phys. 9, 749 (1982); M. Goitein and F. Chen, Med. Phys. 10, 831 (1983); M.R. Raju, Rad. Res. 145, 391 (1996)). It was obtained external proton beams with energies between 15-25 MeV, currents between 2-10 p A and a uniform transversal sections of 40 mm2 approximately. It was realized dosimetric evaluations with CR39 and Makrofol foliation. The irradiations over biological material contained experiences In vivo with laboratory animals, cellular and bacterial crops. It was fixed the optimal conditions of position and immobilization of the Wistar rats breeding for the In vivo studies. It was chosen dilutions and sowing techniques adequate for the exposition at the cellular and bacterial crops beam. (Author)

  9. External beam radiotherapy for thyroid cancer

    The indications for and techniques of external beam radiotherapy for thyroid tumours can be clearly defined in relation to the histological type of tumour and stage of disease. Localized treatment for carcinoma can easily be accomplished as can wide field irradiation for lymphoma. However, when either extensive lateral neck disease is present or tumour extends into the superior mediastinum, it becomes difficult to adequately encompass the required volume without including the spinal cord. Several techniques are described which overcome this problem and thus allow a radical dose to be given without significant risk of transverse myelitis

  10. Longitudinal motion in the SNS external beam simulation experiment

    Using the envelope equation of Neuffer for longitudinal bunch motion, basic parameters are obtained for the SNS/HIF external beam simulation experiment. Solutions of the equation are calculated for zero space charge and zero external focussing and parameters given for bunch compression in the SNS synchrotron and in the external beam line. (U.K.)

  11. Charge collection in an external proton beam

    Results from the measurement of the stability of charge collected from the target and exit foil, or as alternatives, the γ-ray or backscattered proton counts from the exit foil and the Ar X-ray counts from the air path in an external proton beam are presented. These results show that comparative analysis of material mounted in air is reliable, using either the collected charge or the γ-ray counts as the normalizing factor, if there are no earthed objects in close geometry. The backscattered proton counts can also be used, but not the Ar X-ray counts, unless the current is stabilized. The electrical or thermal conductivity of the target and the target to exit foil separation do not affect the proportionality of the collected charge and the γ-ray counts to the charge incident on the target

  12. Optimization approaches for planning external beam radiotherapy

    Gozbasi, Halil Ozan

    Cancer begins when cells grow out of control as a result of damage to their DNA. These abnormal cells can invade healthy tissue and form tumors in various parts of the body. Chemotherapy, immunotherapy, surgery and radiotherapy are the most common treatment methods for cancer. According to American Cancer Society about half of the cancer patients receive a form of radiation therapy at some stage. External beam radiotherapy is delivered from outside the body and aimed at cancer cells to damage their DNA making them unable to divide and reproduce. The beams travel through the body and may damage nearby healthy tissue unless carefully planned. Therefore, the goal of treatment plan optimization is to find the best system parameters to deliver sufficient dose to target structures while avoiding damage to healthy tissue. This thesis investigates optimization approaches for two external beam radiation therapy techniques: Intensity-Modulated Radiation Therapy (IMRT) and Volumetric-Modulated Arc Therapy (VMAT). We develop automated treatment planning technology for IMRT that produces several high-quality treatment plans satisfying provided clinical requirements in a single invocation and without human guidance. A novel bi-criteria scoring based beam selection algorithm is part of the planning system and produces better plans compared to those produced using a well-known scoring-based algorithm. Our algorithm is very efficient and finds the beam configuration at least ten times faster than an exact integer programming approach. Solution times range from 2 minutes to 15 minutes which is clinically acceptable. With certain cancers, especially lung cancer, a patient's anatomy changes during treatment. These anatomical changes need to be considered in treatment planning. Fortunately, recent advances in imaging technology can provide multiple images of the treatment region taken at different points of the breathing cycle, and deformable image registration algorithms can

  13. External beam PIXE analysis of painting

    Pascholati, Paulo R.; Rizzutto, Marcia A.; Barbosa, Marcel D.L.; Albuquerque, Cindy [Sao Paulo Univ., SP (Brazil). Inst. de Fisica]. E-mail: pascholati@if.usp.br; rizzutto@if.usp.br; mbarbosa@if.usp.br; cindy@if.usp.br; Neves, Graziela [Instituto de Pesquisas Energeticas e Nucleares (IPEN), Sao Paulo, SP (Brazil)]. E-mail: graziela@if.usp.br

    2005-07-01

    The preservation and conservation of mankind cultural heritage has become an important issue worldwide. Non-destructive analytical techniques are suitable, for example, to analyze precious and unique objects of art and archaeology. Among those techniques Particle Induced X-Ray Emission (PIXE) has good advantage to identify elemental composition present in these kinds of objects. The Laboratorio de Analise de Materiais por Feixes Ionicos-LAMFI of the Institute of Physics of the University of Sao Paulo has been installed an external beam facility for PIXE analysis. This new setup is being used for the analysis of archaeological pottery artifacts, paintings and biological tissues (teeth and bones), which are not compatible with the high vacuum of the regular PIXE target chamber. In addition most art and archaeological objects are too large for the evacuated analysis chamber. Applications of this facility will be presented in the analysis of one painting of the beginning of the last century. The chemical elements identified in the painting were Ca, Ti, Cr, Cu, Fe, Zn, Pb and Ba. The PIXE measurements were done non-destructively and no visible damage was observed on the irradiated object. (author)

  14. Minimal requirements for quality controls in radiotherapy with external beams

    Physical dosimetric guidelines have been developed by the Italian National Institute of Health study group on quality assurance in radiotherapy to define protocols for quality controls in external beam radiotherapy. While the document does not determine strict rules or firm recommendations, it suggests minimal requirements for quality controls necessary to guarantee an adequate degree of accuracy in external beam radiotherapy

  15. External validation of Adjuvant! Online breast cancer prognosis tool. Prioritising recommendations for improvement.

    David Hajage

    Full Text Available BACKGROUND: Adjuvant! Online is a web-based application designed to provide 10 years survival probability of patients with breast cancer. Several predictors have not been assessed in the original Adjuvant! Online study. We provide the validation of Adjuvant! Online algorithm on two breast cancer datasets, and we determined whether the accuracy of Adjuvant! Online is improved with other well-known prognostic factors. PATIENTS AND METHODS: The French data set is composed of 456 women with early breast cancer. The Dutch data set is composed of 295 women less than 52 years of age. Agreement between observation and Adjuvant! Online prediction was checked, and logistic models were performed to estimate the prognostic information added by risk factors to Adjuvant! Online prediction. RESULTS: Adjuvant! Online prediction was overall well-calibrated in the French data set but failed in some subgroups of such high grade and HER2 positive patients. HER2 status, Mitotic Index and Ki67 added significant information to Adjuvant! Online prediction. In the Dutch data set, the overall 10-year survival was overestimated by Adjuvant! Online, particularly in patients less than 40 years old. CONCLUSION: Adjuvant! Online needs to be updated to adjust overoptimistic results in young and high grade patients, and should consider new predictors such as Ki67, HER2 and Mitotic Index.

  16. Anesthesia for pediatric external beam radiation therapy

    Background: For very young patients, anesthesia is often required for radiotherapy. This results in multiple exposures to anesthetic agents over a short period of time. We report a consecutive series of children anesthetized for external beam radiation therapy (EBRT). Methods: Five hundred twelve children ≤ 16 years old received EBRT from January 1983 to February 1996. Patient demographics, diagnosis, anesthesia techniques, monitoring, airway management, complications, and outcome were recorded for the patients requiring anesthesia. Results: One hundred twenty-three of the 512 children (24%) required 141 courses of EBRT with anesthesia. Anesthetized patients ranged in age from 20 days to 11 years (mean 2.6 ± 1.8 ). The frequency of a child receiving EBRT and requiring anesthesia by age cohort was: ≤ 1 year (96%), 1-2 years (93%), 2-3 years (80%), 3-4 years (51%), 4-5 years (36%), 5-6 years (13%), 6-7 years (11%), and 7-16 years (0.7%). Diagnoses included: primary CNS tumor (28%), retinoblastoma (27%), neuroblastoma (20%), acute leukemia (9%), rhabdomyosarcoma (6%), and Wilms' tumor (4%). Sixty-three percent of the patients had been exposed to chemotherapy prior to EBRT. The mean number of anesthesia sessions per patient was 22 ± 16. Seventy-eight percent of the treatment courses were once daily and 22% were twice daily. Anesthesia techniques included: short-acting barbiturate induction + inhalation maintenance (21%), inhalation only (20%), ketamine (19%), propofol only (12%), propofol induction + inhalation maintenance (7%), ketamine induction + inhalation maintenance (6%), ketamine or short-acting barbiturate induction + inhalation maintenance (6%). Monitoring techniques included: EKG (95%), O2 saturation (93%), fraction of inspired O2 (57%), and end-tidal CO2 (55%). Sixty-four percent of patients had central venous access. Eleven of the 74 children with a central line developed sepsis (15%): 6 of the 11 were anesthetized with propofol (55%), 4 with a short

  17. RC T-Beams Externally Prestressed with Unbonded CFRP

    Schmidt, Jacob Wittrup; Bennitz, Anders; Nilimaa, Jonny;

    2010-01-01

    An experimental test series with seven beams externally prestressed with unbonded CFRP 7 (Carbon Fibre Reinforced Polymer) tendons has been performed. Presence of deviator, initial 8 tendon depth and prestressing force are varied. Results and behaviors are compared to 9 common beam theory, matchi...

  18. CFRP Mechanical Anchorage for Externally Strengthened RC Beams under Flexure

    Ali, Alnadher; Abdalla, Jamal; Hawileh, Rami; Galal, Khaled

    De-bonding of carbon fiber reinforced polymers (CFRP) sheets and plates from the concrete substrate is one of the major reasons behind premature failures of beams that are externally strengthened with such CFRP materials. To delay or prevent de-bonding and therefore enhancing the load carrying capacity of strengthened beams, several anchorage systems were developed and used. This paper investigates the use of CFRP mechanical anchorage of CFRP sheets and plates used to externally strengthen reinforced concrete beams under flexure. The pin-and-fan shape CFRP anchor, which is custom-made from typical rolled fiber sheets and bundles of loose fiber is used. Several reinforced concrete beams were casted and tested in standard four-point bending scheme to study the effectiveness of this anchorage system. The beams were externally strengthened in flexure with bonded CFRP sheets and plates and then fastened to the soffit of the beams' using various patterns of CFRP anchors. It is observed that the CFRP plates begins to separate from the beams as soon as de-bonding occurs in specimens without CFRP anchors, while in beams with CFRP anchors de-bonding was delayed leading to increase in the load carrying capacity over the un-anchored strengthened beams.

  19. Applications of external beam PIXE at RMIT

    Moser, M.; Bubb, I. F.; Johnston, P. N.; El Bouanani, M.; Stannard, W. B.; Short, R. C.

    1998-04-01

    The development of an external Proton Induced X-Ray Emission (PIXE) facility for the 1 MV Tandetron accelerator based at the Royal Melbourne Institute of Technology has enabled the analysis of artefacts from the Museum of Victoria. Analyses of antique bullets, Egyptian glass samples, an Egyptian wall paint fragment and pigments from soils have been carried out. The results from the analysis of antique bullets determined the composition of blue spots on one bullet and aided in the conservation process. External PIXE analysis of two Egyptian glass samples enabled the partial determination of the colouring transition metals. Analysis of an Egyptian wall paint fragment and pigments from soils originating from the archaeological excavation of the town of Ismant el-Kharab as part of the Dakhleh Oasis Project revealed the necessity to find additional pigments to enable identification of the geographical origin of the wall paint.

  20. Applications of external beam PIXE at RMIT

    The development of an external proton induced X-ray emission (PIXE) facility for the 1 MV tandetron accelerator based at Royal Melbourne institute of technology has enabled the analysis of artefacts from the Museum of Victoria. Analyses of antique bullets, Egyptian glass samples, an Egyptian wall paint fragment and pigments from soils have been carried out. The results from the analysis of antique bullets determined the composition of blue spots on one bullet and aided in the conservation process. External PIXE analysis of two Egyptian glass samples enabled the partial determination of the colouring transition metals. Analysis of an Egyptian wall paint fragment and pigments from soils originating from the archaeological excavation of the town of Ismant el-Kharab as part of the Dakhleh Oasis Project revealed the necessity to find additional pigments to enable identification of the geographical origin of the wall paint. (orig.)

  1. Neoadjuvant hormonal therapy and external-beam radiotherapy versus external-beam irradiation alone for prostate cancer. A quality-of-life analysis

    Pinkawa, Michael; Piroth, Marc D.; Asadpour, Branka; Gagel, Bernd; Fischedick, Karin; Siluschek, Jaroslav; Kehl, Mareike; Krenkel, Barbara; Eble, Michael J. [RWTH Aachen (Germany). Dept. of Radiotherapy

    2009-02-15

    To evaluate the impact of neoadjuvant hormonal therapy (NHT) on quality of life after external-beam radiotherapy (EBRT) for prostate cancer. A group of 170 patients (85 with and 85 without NHT) has been surveyed prospectively before EBRT (70.2-72 Gy), at the last day of EBRT, a median time of 2 months and 15 months after EBRT using a validated questionnaire (Expanded Prostate Cancer Index Composite). Pairs with and without NHT (median treatment time of 3.5 months before EBRT) were matched according to the respective planning target volume and prostate volume. Before EBRT, significantly lower urinary function/bother, sexual function and hormonal function/bother scores were found for patients with NHT. More than 1 year after EBRT, only sexual function scores remained lower. In a multivariate analysis, NHT and adjuvant hormonal therapy (HT) versus NHT only (hazard ratio 14; 95% confidence interval 2.7-183; p = 0.02) and luteinizing hormone-releasing hormone (LHRH) agonists versus antiandrogens (hazard ratio 3.6; 95% confidence interval 1.1-12; p = 0.04) proved to be independent risk factors for long-term erectile dysfunction (no or very poor ability to have an erection). With the exception of sexual function (additional adjuvant HT and application of LHRH analog independently adverse), short-term NHT was not found to decrease quality of life after EBRT for prostate cancer. (orig.)

  2. Neoadjuvant hormonal therapy and external-beam radiotherapy versus external-beam irradiation alone for prostate cancer. A quality-of-life analysis

    To evaluate the impact of neoadjuvant hormonal therapy (NHT) on quality of life after external-beam radiotherapy (EBRT) for prostate cancer. A group of 170 patients (85 with and 85 without NHT) has been surveyed prospectively before EBRT (70.2-72 Gy), at the last day of EBRT, a median time of 2 months and 15 months after EBRT using a validated questionnaire (Expanded Prostate Cancer Index Composite). Pairs with and without NHT (median treatment time of 3.5 months before EBRT) were matched according to the respective planning target volume and prostate volume. Before EBRT, significantly lower urinary function/bother, sexual function and hormonal function/bother scores were found for patients with NHT. More than 1 year after EBRT, only sexual function scores remained lower. In a multivariate analysis, NHT and adjuvant hormonal therapy (HT) versus NHT only (hazard ratio 14; 95% confidence interval 2.7-183; p 0.02) and luteinizing hormone-releasing hormone (LHRH) agonists versus antiandrogens (hazard ratio 3.6; 95% confidence interval 1.1-12; p = 0.04) proved to be independent risk factors for long-term erectile dysfunction (no or very poor ability to have an erection). With the exception of sexual function (additional adjuvant HT and application of LHRH analog independently adverse), short-term NHT was not found to decrease quality of life after EBRT for prostate cancer. (orig.)

  3. Monitoring external beam radiotherapy using real-time beam visualization

    Jenkins, Cesare H. [Department of Mechanical Engineering and Department of Radiation Oncology, Stanford University, Stanford, California 94305 (United States); Naczynski, Dominik J.; Yu, Shu-Jung S.; Xing, Lei, E-mail: lei@stanford.edu [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California 94305 (United States)

    2015-01-15

    Purpose: To characterize the performance of a novel radiation therapy monitoring technique that utilizes a flexible scintillating film, common optical detectors, and image processing algorithms for real-time beam visualization (RT-BV). Methods: Scintillating films were formed by mixing Gd{sub 2}O{sub 2}S:Tb (GOS) with silicone and casting the mixture at room temperature. The films were placed in the path of therapeutic beams generated by medical linear accelerators (LINAC). The emitted light was subsequently captured using a CMOS digital camera. Image processing algorithms were used to extract the intensity, shape, and location of the radiation field at various beam energies, dose rates, and collimator locations. The measurement results were compared with known collimator settings to validate the performance of the imaging system. Results: The RT-BV system achieved a sufficient contrast-to-noise ratio to enable real-time monitoring of the LINAC beam at 20 fps with normal ambient lighting in the LINAC room. The RT-BV system successfully identified collimator movements with sub-millimeter resolution. Conclusions: The RT-BV system is capable of localizing radiation therapy beams with sub-millimeter precision and tracking beam movement at video-rate exposure.

  4. Monitoring external beam radiotherapy using real-time beam visualization

    Purpose: To characterize the performance of a novel radiation therapy monitoring technique that utilizes a flexible scintillating film, common optical detectors, and image processing algorithms for real-time beam visualization (RT-BV). Methods: Scintillating films were formed by mixing Gd2O2S:Tb (GOS) with silicone and casting the mixture at room temperature. The films were placed in the path of therapeutic beams generated by medical linear accelerators (LINAC). The emitted light was subsequently captured using a CMOS digital camera. Image processing algorithms were used to extract the intensity, shape, and location of the radiation field at various beam energies, dose rates, and collimator locations. The measurement results were compared with known collimator settings to validate the performance of the imaging system. Results: The RT-BV system achieved a sufficient contrast-to-noise ratio to enable real-time monitoring of the LINAC beam at 20 fps with normal ambient lighting in the LINAC room. The RT-BV system successfully identified collimator movements with sub-millimeter resolution. Conclusions: The RT-BV system is capable of localizing radiation therapy beams with sub-millimeter precision and tracking beam movement at video-rate exposure

  5. Treatment machines for external beam radiotherapy

    Since the inception of radiotherapy soon after the discovery of X rays by Roentgen in 1895, the technology of X ray production has first been aimed towards ever higher photon and electron beam energies and intensities, and more recently towards computerization and intensity modulated beam delivery. During the first 50 years of radiotherapy the technological progress was relatively slow and mainly based on X ray tubes, van de Graaff generators and betatrons. The invention of the 60Co teletherapy unit by H.E. Johns in Canada in the early 1950s provided a tremendous boost in the quest for higher photon energies and placed the cobalt unit at the forefront of radiotherapy for a number of years. The concurrently developed medical linacs, however, soon eclipsed cobalt units, moved through five increasingly sophisticated generations and became the most widely used radiation source in modern radiotherapy. With its compact and efficient design, the linac offers excellent versatility for use in radiotherapy through isocentric mounting and provides either electron or megavoltage X ray therapy with a wide range of energies. In addition to linacs, electron and X ray radiotherapy is also carried out with other types of accelerator, such as betatrons and microtrons. More exotic particles, such as protons, neutrons, heavy ions and negative p mesons, all produced by special accelerators, are also sometimes used for radiotherapy; however, most contemporary radiotherapy is carried out with linacs or teletherapy cobalt units

  6. Ion beam analysis with external beams: Recent set-up improvements

    Accelerator-based analytical techniques using external beams are ideally fitted to the study of works of art because of their fully non-destructive character. However, accurate quantitative analysis is not straightforward, due in particular to difficult beam monitoring. Significant improvements have been progressively made on the external beam line of the IBA facility of the Louvre museum in order to increase the accuracy and to conduct combined analyses with different IBA techniques

  7. Development of an external Faraday cup for beam current measurements

    In general, beam current measurements are very important for many kinds of experiments using highly energetic particle beams at accelerators, such as cyclotrons, linacs, etc. The Faraday cup is known to be one of the most popular beam current measurement tools. We developed an external Faraday cup to measure the beam current at a dedicated beam line for low-flux experiments installed at the MC-50 cyclotron of Korea Institute of Radiological and Medical Sciences (KIRAMS). It was designed for external beam current measurements and is composed of a vacuum chamber, an entrance window, a collimator, a electrostatic suppressor ring, and a cup. The window is made of 75-um-thick Kapton film, and the diameter of the collimator is 10 mm or 20 mm. The ring and the cup has 5-cm inner diameters, and the thickness of the bottom of the cup is 2 cm, which is enough to absorb the total proton energy up to 45 MeV. Using this external Faraday cup, we measured the beam current from the cyclotron, and we compared measured flux to the results from film dosimetry using GAF films.

  8. Prospective survey of erectile dysfunction after external beam radiotherapy for prostate cancer

    We prospectively evaluated the effect of external beam radiotherapy on erectile function in patients with localized or locally advanced prostate cancer using the Japanese version of the International Index of Erectile Function (IIEF) survey. From 2000 to 2007, we identified 55 patients who underwent external beam radiotherapy at our institution for localized or locally advanced prostate cancer and could respond to the IIEF survey. The patients did not receive neo- and/or adjuvant hormone therapy and they were followed-up for at least 12 months after radiotherapy. Mean patient age was 69 years and the mean prostate specific antigen (PSA) level before radiotherapy was 24.9 ng/ml. First we evaluated the change of the erectile function domain score over time before and after radiotherapy. The population of severe erectile dysfunction (ED) increased while those with no or mild ED decreased after radiotherapy. The erectile function and intercourse satisfaction domain score of the IIEF declined significantly after radiotherapy, however, the orgasmic function, sexual desire, and overall satisfaction domain scores did not change after external beam radiation. Of the 34 patients who had erectile function at baseline, 10 patients could maintain erectile function 12 months after radiotherapy. Though there were no significant differences in clinical features between patients who could maintain erectile function and those who had worsening erectile function 12 months after radiotherapy, the sexual desire domain score before radiotherapy was significantly higher in patients who could maintain erectile function than their counterparts. Using the IIEF survey, external beam radiation was found to affect erectile function in patients with localized or locally advanced prostate cancer. (author)

  9. Study on external beam radiation therapy

    Kim, Mi Sook; Yoo, Seoung Yul; Yoo, Hyung Jun; Ji, Young Hoon; Lee, Dong Han; Lee, Dong Hoon; Choi, Mun Sik; Yoo, Dae Heon; Lee, Hyo Nam; Kim, Kyeoung Jung

    1999-04-01

    To develop the therapy technique which promote accuracy and convenience in external radiation therapy, to obtain the development of clinical treatment methods for the global competition. The contents of the R and D were 1. structure, process and outcome analysis in radiation therapy department. 2. Development of multimodality treatment in radiation therapy 3. Development of computation using networking techniques 4. Development of quality assurance (QA) system in radiation therapy 5. Development of radiotherapy tools 6. Development of intraoperative radiation therapy (IORT) tools. The results of the R and D were 1. completion of survey and analysis about Korea radiation therapy status 2. Performing QA analysis about ICR on cervix cancer 3. Trial of multicenter randomized study on lung cancers 4. Setting up inter-departmental LAN using MS NT server and Notes program 5. Development of ionization chamber and dose-rate meter for QA in linear accelerator 6. Development on optimized radiation distribution algorithm for multiple slice 7. Implementation on 3 dimensional volume surface algorithm and 8. Implementation on adaptor and cone for IORT.

  10. Study on external beam radiation therapy

    To develop the therapy technique which promote accuracy and convenience in external radiation therapy, to obtain the development of clinical treatment methods for the global competition. The contents of the R and D were 1. structure, process and outcome analysis in radiation therapy department. 2. Development of multimodality treatment in radiation therapy 3. Development of computation using networking techniques 4. Development of quality assurance (QA) system in radiation therapy 5. Development of radiotherapy tools 6. Development of intraoperative radiation therapy (IORT) tools. The results of the R and D were 1. completion of survey and analysis about Korea radiation therapy status 2. Performing QA analysis about ICR on cervix cancer 3. Trial of multicenter randomized study on lung cancers 4. Setting up inter-departmental LAN using MS NT server and Notes program 5. Development of ionization chamber and dose-rate meter for QA in linear accelerator 6. Development on optimized radiation distribution algorithm for multiple slice 7. Implementation on 3 dimensional volume surface algorithm and 8. Implementation on adaptor and cone for IORT

  11. Place and technical aspects of external beam radiation therapy in the treatment of adult soft tissue sarcomas

    In soft tissue sarcoma, surgical resection remains the cornerstone of therapy for localized disease. Quality of margins is very important evaluate. In case of marginal or incomplete resection, a new enlarged surgical resection should always be discussed before administration of an adjuvant treatments. Many retrospective studies and 2 randomized studies (one of adjuvant brachytherapy and one of external beam radiotherapy) have shown that adjuvant radiotherapy after complete surgery reduces significantly the risk of local recurrence in extremity soft tissue sarcomas. Combination of surgery and pre- or postoperative radiotherapy has therefore become the standard treatment with a local recurrence rate ≤ 25 % and very few amputations. A recent randomized study has compared pre-op to postoperative radiotherapy. The results in terms of local control are similar in both arms (93 and 92% at 5 years) but the risk of early complications is higher in the preoperative arm and the risk of late sequela is higher in the postoperative arm. Surgical resection without radiotherapy may be considered after discussion at best within a multidisciplinary meeting, if surgical margins are considered satisfactory, in superficial, small tumours and low-grade. In retroperitoneal sarcomas, adjuvant radio-therapy is not a standard. It may decrease the risk of local recurrence but at the price of an increased gastro-intestinal toxicity. A randomized trial is warranted. Because of its rarity, and the risk of recurrence both local and metastatic, treatment should preferentially be discussed with a multimodality specialized approach. (author)

  12. Issues in respiratory motion compensation during external-beam radiotherapy

    Purpose: To investigate how respiration influences the motion of lung and pancreas tumors and to relate the observations to treatment procedures intended to improve dose alignment by predicting the moving tumor's position from external breathing indicators. Methods and materials: Breathing characteristics for five healthy subjects were observed by optically tracking the displacement of the chest and abdomen, and by measuring tidal air volume with a spirometer. Fluoroscopic imaging of five radiotherapy patients detected the motion of lung and pancreas tumors synchronously with external breathing indicators. Results: The external and fluoroscopic data showed a wide range of behavior in the normal breathing pattern and its effects on the position of lung and pancreas tumors. This included transient phase shifts between two different external measures of breathing that diminished to zero over a period of minutes, modulated phase shifts between tumor and chest wall motion, and other complex phenomena. Conclusions: Respiratory compensation strategies that infer tumor position from external breathing signals, including methods of beam gating and dynamic beam tracking, require three-dimensional knowledge of the tumor's motion trajectory as well as the ability to detect and adapt to transient and continuously changing characteristics of respiratory motion during treatment

  13. UCN Source at an External Beam of Thermal Neutrons

    2015-01-01

    We propose a new method for production of ultracold neutrons (UCNs) in superfluid helium. The principal idea consists in installing a helium UCN source into an external beam of thermal or cold neutrons and in surrounding this source with a solid methane moderator/reflector cooled down to ~4 K. The moderator plays the role of an external source of cold neutrons needed to produce UCNs. The flux of accumulated neutrons could exceed the flux of incident neutrons due to their numerous reflections ...

  14. External beam radiotherapy for retinoblastoma: Pt. 1: Whole eye technique

    A retrospective analysis has been performed of the results of external beam radiotherapy for retinoblastoma using a whole eye technique. Local tumour control has been assessed in a consecutive series of 175 eyes in 142 children all of whom received external beam radiotherapy as the primary treatment for retinoblastoma. Follow up ranged from 2 to 17 years (median 9 years). Tumour control rates have been analysed with respect to the Reese Ellsworth classification and the series includes eyes in groups I to V. Focal salvage therapy was given for persistent, recurrent, or new tumours after radiotherapy. Following whole eye radiotherapy alone, the overall ocular cure rate was 57%, though with salvage therapy 80% of eyes could be preserved. (author)

  15. External beam and radioimmunotherapy dosimetry comparison of colorectal xenografts

    It is of little surprise to most experts in radiation dosimetry that the largest uncertainties associated with calculation of absorbed doses to tumor normal tissues after IV administration of radiolabeled antibodies, does not lie in the calculation methods but rather in the acquisition of time-dependent activity data. In comparison to external beam radiation dosimetry, the problems of temporal and spatial macroscopic and microscopic heterogeneities continue to confound one's best efforts. In fact in some clinical settings, only a radiobiological end-point such as hematopoietic depression is used exclusively with no reference made to absorbed dose quantitation at all. Hence in these cases, it is most practical to simply relate administered activity directly with radiobiological response. To help provide a correlation between activity, absorbed dose and radiobiological response, animal radioimmunotherapy (RIT) experiments were performed here in which the above parameters were measured and compared with multiple dose levels of external beam irradiation. Using the LS174T colorectal xenograft model in nude mice, administered activities of up to 18.5 MBq of I-131 labeled B72.3 delivered an average measured absorbed dose to tumor of 3.2 ± 0.5 cGy/3.7 x 104 Bq. This absorbed dose (1,440 cGy from a nominal 17 MBq administered activity) produced tumor growth delay values that were comparable to a dose of 2,250 cGy on average delivered by single fraction external beam radiation therapy. An average dose enhancement ratio was calculated at 1.6 for RIT as compared with external beam therapy. This enhancement ratio ranged from 1.0-2.4 for several experimental repetitions under a variety of initial conditions

  16. The use of beam code in external radiotherapy; Utilisation du code beam en radiotherapie externe

    Guillerminet, C.; Gschwind, R.; Makovicka, L. [CREST - UMR 6000 CNRS, 25 - Montbeliard (France)

    2003-07-01

    This code, in constant evolution, has several assets because it allows in one hand to better characterize the beams at the energy and angular level of accelerators at medical use; these data being accessible only by simulation and on the other hand to establish a three dimensional dose calculation fro any phantom. The limit factors are the calculation time, the size of voxels need important dimension tables for the data storage, and the compatibility between the code and the different images formats. (N.C.)

  17. Development and Commissioning of an External Beam Facility in the Union College Ion Beam Analysis Laboratory

    Yoskowitz, Joshua; Clark, Morgan; Labrake, Scott; Vineyard, Michael

    2015-10-01

    We have developed an external beam facility for the 1.1-MV tandem Pelletron accelerator in the Union College Ion Beam Analysis Laboratory. The beam is extracted from an aluminum pipe through a 1 / 4 ' ' diameter window with a 7.5- μm thick Kapton foil. This external beam facility allows us to perform ion beam analysis on samples that cannot be put under vacuum, including wet samples and samples too large to fit into the scattering chamber. We have commissioned the new facility by performing proton induced X-ray emission (PIXE) analysis of several samples of environmental interest. These include samples of artificial turf, running tracks, and a human tooth with an amalgam filling. A 1.7-MeV external proton beam was incident on the samples positioned 2 cm from the window. The resulting X-rays were measured using a silicon drift detector and were analyzed using GUPIX software to determine the concentrations of elements in the samples. The results on the human tooth indicate that while significant concentrations of Hg, Ag, and Sn are present in the amalgam filling, only trace amounts of Hg appear to have leached into the tooth. The artificial turf and running tracks show rather large concentrations of a broad range of elements and trace amounts of Pb in the turf infill.

  18. Trace element fingerprinting of jewellery rubies by external beam PIXE

    Calligaro, T. E-mail: calli@culture.nl; Poirot, J.-P.; Querre, G

    1999-04-02

    External beam PIXE analysis allows the non-destructive in situ characterisation of gemstones mounted on jewellery pieces. This technique was used for the determination of the geographical origin of 64 rubies set on a high-valued necklace. The trace element content of these gemstones was measured and compared to that of a set of rubies of known sources. Multivariate statistical processing of the results allowed us to infer the provenance of rubies: one comes from Thailand/Cambodia deposit while the remaining are attributed to Burma. This highlights the complementary capabilities of PIXE and conventional geological observations.

  19. Trace element fingerprinting of jewellery rubies by external beam PIXE

    Calligaro, T.; Poirot, J.-P.; Querré, G.

    1999-04-01

    External beam PIXE analysis allows the non-destructive in situ characterisation of gemstones mounted on jewellery pieces. This technique was used for the determination of the geographical origin of 64 rubies set on a high-valued necklace. The trace element content of these gemstones was measured and compared to that of a set of rubies of known sources. Multivariate statistical processing of the results allowed us to infer the provenance of rubies : one comes from Thailand/Cambodia deposit while the remaining are attributed to Burma. This highlights the complementary capabilities of PIXE and conventional gemological observations.

  20. External-beam irradiation of carcinoma of the penis

    Twenty-four patients with biopsy-proved squamous-cell carcinoma of the penis underwent external-beam radiation therapy between 1966 and 1980. Fifteen were treated for the primary tumor and 9 for metastatic inguinal lymphadenopathy; no patient received prophylactic nodal irradiation. Seven out of 9 tumors in stage I, 2/3 in stage II, and 1/3 in stage IV were controlled for three years. Control of fixed, inoperable groin nodes was poor, and none of these patients survived beyond 1 1/2 years

  1. RBS and NRA with external beams for archaeometric applications

    Combined RBS and NRA measurements at atmospheric pressure have been performed on copper alloys of archaeological significance with external beams of, respectively, 3-MeV protons and 2-MeV deuterons. The objective is to determine the structure and composition of the patina through the depth profiles of the constituent elements, particularly C, N, O, obtained by (d,p) nuclear reactions. An iterative fitting procedure of both RBS and NRA spectra permits to reach this goal with a high degree of confidence

  2. Trace element fingerprinting of jewellery rubies by external beam PIXE

    External beam PIXE analysis allows the non-destructive in situ characterisation of gemstones mounted on jewellery pieces. This technique was used for the determination of the geographical origin of 64 rubies set on a high-valued necklace. The trace element content of these gemstones was measured and compared to that of a set of rubies of known sources. Multivariate statistical processing of the results allowed us to infer the provenance of rubies: one comes from Thailand/Cambodia deposit while the remaining are attributed to Burma. This highlights the complementary capabilities of PIXE and conventional geological observations

  3. Analysis of an ancient bronze statue by external beam pixe

    A quantitative analysis of an ancient Buddha statue was performed by external beam Proton Induced X-ray Emission for the purpose of identifying its originality. It is shown how the PIXE method can be applied for archeological study. The elemental composition of the statue is compared with that of several samples with definite ages. The experiment was performed by extracting 2.4 MeV proton beam through a 2 mm diameter collimator and 7.6 μm kapton foil to the He atmosphere. X-rays were measured by a Si(Li) detector. The analysed elements were Fe, Cu, Ag, Au and Hg for gold coating and Fe, Ni, Cu, Zn, As, Ag, Sn, Au, Pb and Bi for bronze body. (author) 11 refs.; 4 figs.; 2 tabs

  4. ULTIMATE FLEXURAL BEHAVIOUR OF EXTERNALLY PRESTRESSED NEW BEAMS AND DISTRESSED BEAMS

    R. SENTHIL

    2015-04-01

    Full Text Available External prestressing has become a popular technique in retrofitting of distressed concrete structures, mainly bridges. It is being successfully used in segmental construction of new bridges, which is evident in metro constructions and other types of bridges. Tendons used in external prestressing are unbonded tendons and therefore they are analytically treated as internal unbonded tendons. Stress at ultimate in unbonded tendons, fps is the parameter used to evaluate the ultimate flexural capacity of a concrete member prestressed with unbonded tendons. As far as new members are concerned, sufficient research works were carried out on predicting the ultimate flexural behavior and developing equations for finding fps. Therefore, an in depth review has been done on the subject and the behavioural mechanism regarding evaluating ultimate flexural capacity are discussed. As far as distressed concrete members are concerned, an analytical model has been developed for a cracked RC beams strengthened by external prestressing and validated with experimental data, and the results are presented and discussed. The difference in behavior of externally prestressed new beams and distressed beams strengthened by external prestressing are discussed.

  5. Cosmetic results in early breast cancer treated with lumpectomy, peri-operative interstitial irradiation, and external beam radiation

    Patients with operable breast cancer were treated at the University of Kansas Medical Center with lumpectomy, peri-operative interstitial Iridium, and external beam radiotherapy, and concomitant adjuvant chemotherapy in a majority of node positive cases. Examination of the cosmetic results in 85 breasts followed for at least 2 years, at a median of 41 months revealed 20% to be excellent, 44% to be very good, 24% good, 9% fair, and 4% to have poor results. In this paper cosmesis is analyzed with reference to the size of the primary, its location, age of the patient, whether the patient received adjuvant chemotherapy, and whether the regional nodes were treated. In this group of patients, the size and the site of the primary, patient's age, and whether adjuvant chemotherapy was administered or not, did not adversely affect the aesthetic outcome. Treatment of the regional nodes gave a worse mean cosmetic score compared to the group in whom only the breast was treated (37.51 vs. 58.98 respectively, p less than 0.001). Among the 11 patients with fair/poor cosmesis, all had regional nodal treatment, 7/11 had inner quadrant lesions, and 7/11 had lesions greater than T1. Further follow-up and accrual would be needed to confirm our results and affirm if other factors would change

  6. UCN Source at an External Beam of Thermal Neutrons

    E. V. Lychagin

    2015-01-01

    Full Text Available We propose a new method for production of ultracold neutrons (UCNs in superfluid helium. The principal idea consists in installing a helium UCN source into an external beam of thermal or cold neutrons and in surrounding this source with a solid methane moderator/reflector cooled down to ~4 K. The moderator plays the role of an external source of cold neutrons needed to produce UCNs. The flux of accumulated neutrons could exceed the flux of incident neutrons due to their numerous reflections from methane; also the source size could be significantly larger than the incident beam diameter. We provide preliminary calculations of cooling of neutrons. These calculations show that such a source being installed at an intense source of thermal or cold neutrons like the ILL or PIK reactor or the ESS spallation source could provide the UCN density 105 cm−3, the production rate 107 UCN/s−1. Main advantages of such an UCN source include its low radiative and thermal load, relatively low cost, and convenient accessibility for any maintenance. We have carried out an experiment on cooling of thermal neutrons in a methane cavity. The data confirm the results of our calculations of the spectrum and flux of neutrons in the methane cavity.

  7. UCN Source at an External Beam of Thermal Neutrons

    We propose a new method for production of ultracold neutrons (UCNs) in superfluid helium. The principal idea consists in installing a helium UCN source into an external beam of thermal or cold neutrons and in surrounding this source with a solid methane moderator/reflector cooled down to ~4 K. The moderator plays the role of an external source of cold neutrons needed to produce UCNs. The flux of accumulated neutrons could exceed the flux of incident neutrons due to their numerous reflections from methane; also the source size could be significantly larger than the incident beam diameter. We provide preliminary calculations of cooling of neutrons. These calculations show that such a source being installed at an intense source of thermal or cold neutrons like the ILL or PIK reactor or the ESS spallation source could provide the UCN density 105 cm−3, the production rate 107 UCN/s−1. Main advantages of such an UCN source include its low radiative and thermal load, relatively low cost, and convenient accessibility for any maintenance. We have carried out an experiment on cooling of thermal neutrons in a methane cavity. The data confirm the results of our calculations of the spectrum and flux of neutrons in the methane cavity

  8. Calibration of reference dosimeters for external beam radiotherapy

    Traceability, accuracy and consistency of radiation measurements are essential in radiation dosimetry, particularly in radiotherapy, where the outcome of treatments is highly dependent on the radiation dose delivered to patients. The role of Secondary Standards Dosimetry Laboratories (SSDLs) is crucial in providing traceable calibrations to hospitals, since they disseminate calibrations at specific radiation qualities appropriate to the use of radiation measuring instruments. To contribute to harmonization and consistency in radiation measurements, the IAEA and the World Health Organization (WHO) created a network of SSDLs in 1976. To provide SSDLs with a practical guide on calibration and quality control procedures in radiotherapy dosimetry, the IAEA published a manual in 1995 entitled Calibration of Dosimeters Used in Radiotherapy (Technical Reports Series (TRS) No. 374). The manual was a revision of a report, Calibration of Dose Meters Used in Radiotherapy (TRS-185), published in 1979. Although much of TRS-374 remains relevant, there are a number of reasons for preparing a new report, including the development of new dosimetry standards and an increased emphasis on implementing quality assurance systems to help calibration laboratories provide documented assurance to the user community of their commitment to offering consistent and reliable results. This report is not simply a revision of TRS-374, and should be regarded as a new publication with a new structure. Nevertheless, some material, especially that related to the calibration of dosimeters in terms of air kerma for kilovoltage X rays, has been extracted from TRS-374. It fulfils the need for a systematic and standardized approach to the calibration of reference dosimeters used in external beam radiotherapy by the SSDLs. It provides a framework for the operation of an SSDL within the international measurement system, a methodology for the calibration of instruments, and related quality control procedures to

  9. Clinical results of iridium-192 high dose rate brachytherapy with external beam radiotherapy

    Here, we report the clinical results of iridium-192 high dose rate brachytherapy at Kanazawa University Hospital. The study population consisted of 166 patients diagnosed with T1c-T3bN0M0 prostate cancer treated with high dose rate brachytherapy and external beam radiotherapy and followed up for 6 months or longer. Treatment consisted of external beam radiotherapy to the prostate at 44 Gy/22 fractions and high dose rate brachytherapy at 18 Gy/3 fractions. Median follow-up interval was 31.5 months (range 6.2-88.7). The overall 5-year biological recurrence-free survival rate was 93.0%. The 5-year biological recurrence-free survival rates for the patients in low-, intermediate- and high-risk groups according to the D'Amico risk classification criteria were 96.1%, 89.0% and 91.6%, respectively. When limited to the group that did not receive adjuvant hormonal therapy, the 5-year biological recurrence-free survival rates for the patients in low-, intermediate- and high-risk groups were 96.0%, 96.3% and 82.9%, respectively. Grade 3 or greater adverse effects were rare. Urethral stricture was observed in only 1.0% of the patients. Eighty percent of patients retained erectile function after high dose rate brachytherapy and reported satisfaction with sexual function. High dose rate brachytherapy is considered a good form of treatment for localized prostate cancer, although longer follow-up is necessary. (author)

  10. DUCTILITY BEHAVIOR FIBER REINFORCED CONCRETE BEAMS STRENGTHENED WITH EXTERNALLY BONDED GLASS FIBER REINFORCED POLYMER LAMINATES

    Mariappan Mahalingam

    2013-01-01

    Full Text Available The study presents the results of an experimental investigation conducted on Steel Fiber Reinforced Concrete (SFRC beams with externally bonded Glass Fiber Reinforced Polymer (GFRP laminates with a view to study their strength and ductility. A total of ten beams, 150×250 mm in cross-section were tested in the laboratory over an effective span of 2800 mm. Three fiber reinforced concrete beams were used as reference beams. Six fiber reinforced concrete beams were provided with externally bonded GFRP laminates. One concrete beam was left virgin without any fiber reinforcement and external GFRP laminates. All the beams were tested until failure. The variables considered included volume fraction of fiber reinforcement and stiffness of GFRP laminates. The static responses of all the beams were evaluated in terms of strength, stiffness and ductility. The test results show that the beams provided with externally bonded GFRP laminates exhibit improved performance over the beams with internal fiber reinforcement.

  11. Concomitant and adjuvant androgen deprivation (A.D.T.) with external beam irradiation (R.T.) for locally advanced prostate cancer: 6 months versus 3 years A.D.T.--results of the randomized E.O.R.T.C. phase 3 trial 22961

    Bolla, M.; Van Tienhoven, G.; Reijke, T.M. de; Van den Bergh, A.C.; Van der Meijden, A.P.; Poortmans, P.M.; Grez, E.; Kil, P.; Pierart, M.; Collette, L

    2008-01-15

    Background - After EORTC trial 22863, 3 years of endocrine treatment has become standard adjuvant treatment to RT for locally advanced prostate cancer. EORTC 22961 tests if similar survival can be achieved in patients who underwent EBRT (to 70 Gy) and 6 months of combined ADT without further ADT (SADT arm) as in patients with 2.5 years of further treatment with luteinizing hormone-releasing hormone agonist mono-therapy (LADT arm). Methods: Eligible patients had T1c-2b N1-2 or pN1-2, or T2c-4 NO-2 (UICC 1992) MO prostate cancer with PSA <150 ng/ml. Non-inferior survival was defined as a morality hazard ratio (HR) = 1.35 for SADT vs LADT. Non inferiority at 80% power and 1-sided a=0.05 required 275 deaths. A stopping boundary was applied at 1-sided a=0.018. Results: 970 patients were randomized (483 SADT and 487 LADT). At 5.2 years median follow-up, 173 patients had died (100 vs 73). An Independent Data Monitoring Committee recommended disclosure of results based on an interim analysis showing futility. Patient characteristics were well balanced: median age 69 years, WHO PS 0 in 83.4%, most patients had T2c-T3 NO disease. Progression (mostly biochemical and/or bone progression) occurred in 220 cases (159 on SADT vs 61 on LADT) and was treated by secondary hormonal manipulation. The 5-year overall survival rate was 85.3% on LADT and 80.6% on SADT (HR=1.43, 96.4% CI: 1.04-1.98), and failed to prove non-inferiority. The 5-year clinical progression-free survival rate was 81.8% on LADT versus 68.9% on SADT arm and the 5-year biochemical progression-free survival rate was 78.3% on LADT versus 58.9% on SADT, indicating inferiority of SADT with HR=1.93 and HR=2.29, respectively. Conclusions - The study was designed to demonstrate non-inferior survival with 6 months ADT compared to 3 years adjuvant ADT after irradiation for patients with locally advanced prostate cancer, but observed survival data indicate that non-inferiority cannot be confirmed. Progression-free survival

  12. DUCTILITY BEHAVIOR FIBER REINFORCED CONCRETE BEAMS STRENGTHENED WITH EXTERNALLY BONDED GLASS FIBER REINFORCED POLYMER LAMINATES

    Mariappan Mahalingam; Ragunath Pulipakka Narashima Rao; Suguna Kannan

    2013-01-01

    The study presents the results of an experimental investigation conducted on Steel Fiber Reinforced Concrete (SFRC) beams with externally bonded Glass Fiber Reinforced Polymer (GFRP) laminates with a view to study their strength and ductility. A total of ten beams, 150Ã250 mm in cross-section were tested in the laboratory over an effective span of 2800 mm. Three fiber reinforced concrete beams were used as reference beams. Six fiber reinforced concrete beams were provided with externally bond...

  13. Computerized treatment planning systems for external photon beam radiotherapy

    Computerized treatment planning systems (TPSs) are used in external beam radiotherapy to generate beam shapes and dose distributions with the intent to maximize tumour control and minimize normal tissue complications. Patient anatomy and tumour targets can be represented as 3-D models. The entire process of treatment planning involves many steps and the medical physicist is responsible for the overall integrity of the computerized TPS to accurately and reliably produce dose distributions and associated calculations for external beam radiotherapy. The planning itself is most commonly carried out by a dosimetrist, and the plan must be approved by a radiation oncologist before implementation in actual patient treatments. Treatment planning prior to the 1970s was generally carried out through the manual manipulation of standard isodose charts on to patient body contours that were generated by direct tracing or lead wire representation, and relied heavily on the judicious choice of beam weight and wedging by an experienced dosimetrist. The simultaneous development of computed tomography (CT), along with the advent of readily accessible computing power from the 1970s on, led to the development of CT based computerized treatment planning, providing the ability to view dose distributions directly superimposed upon a patient's axial anatomy. The entire treatment planning process involves many steps, beginning from beam data acquisition and entry into the computerized TPS, through patient data acquisition, to treatment plan generation and the final transfer of data to the treatment machine. Successive improvements in treatment planning hardware and software have been most notable in the graphics, calculation and optimization aspects of current systems. Systems encompassing the 'Virtual Patient' are able to display beam's eye views (BEVs) of radiation beams and digitally reconstructed radiographs (DRRs) for arbitrary dose distributions. Dose calculations have evolved from

  14. Development of an external beam facility for PIXE at RMIT

    An external Proton Induced X-Ray Emission (PIXE) facility for the 1 MV Tandetron accelerator based at Royal Melbourne Institute of Technology has been developed. The 0.35 mm diameter focused beam of 1.6 MeV protons reaches the target after traversing 8 μm Kapton foil coated with gold and 13.5 mm of air. For quantitative analysis, the number of protons hitting the target was determined by the number of backscattered protons from the inner layer of gold on the window foil. Radiation damage causes the Kapton window to exhibit increasing inward diffusion of air. This provides an excellent mechanism for determining the need to replace the window foil before it ruptures. The facility has been used to make non-destructive measurements of the composition of samples from the Museum of Victoria

  15. Olfactory neural tumours - the role of external beam radiotherapy

    Slevin, N.J.; Irwin, C.J.R.; Banerjee, S.S.; Path, F.R.C.; Gupta, N.K.; Farrington, W.T. [Christie Hospital and Holt Radium Inst., Manchester (United Kingdom)

    1996-11-01

    Olfactory neuroblastoma is an uncommon tumour arising in the nasal cavity or paranasal sinuses. We report the management of nine cases treated with external beam radiotherapy subsequent to surgery, either attempted definitive removal or biopsy only. Recent refinements in pathological evaluation of these tumours are discussed. Seven cases were deemed classical olfactory neuroblastoma whilst two were classified as neuroendocrine carcinoma. The clinical features, radiotherapy technique and variable natural history are presented. Seven of eight patients treated radically were controlled locally, with a minimum follow-up of two years. Three patients developed cervical lymph node disease and three patients died of systemic metastatic disease. Suggestions are made as to which patients should have en-bloc resection rather than definitive radiotherapy. (author).

  16. Olfactory neural tumours - the role of external beam radiotherapy

    Olfactory neuroblastoma is an uncommon tumour arising in the nasal cavity or paranasal sinuses. We report the management of nine cases treated with external beam radiotherapy subsequent to surgery, either attempted definitive removal or biopsy only. Recent refinements in pathological evaluation of these tumours are discussed. Seven cases were deemed classical olfactory neuroblastoma whilst two were classified as neuroendocrine carcinoma. The clinical features, radiotherapy technique and variable natural history are presented. Seven of eight patients treated radically were controlled locally, with a minimum follow-up of two years. Three patients developed cervical lymph node disease and three patients died of systemic metastatic disease. Suggestions are made as to which patients should have en-bloc resection rather than definitive radiotherapy. (author)

  17. Normal tissue tolerance to external beam radiation therapy: Small bowel

    The small bowel is a hollow organ involved in the transit and absorption of food. In relation to its anatomical location, a significant amount of this organ is exposed in whole or in part to ionizing radiation in external radiotherapy during abdominal or pelvic irradiation either for primary cancers or metastasis. The acute functional changes during external beam radiation are mainly leading to diarrhea, abdominal pain and bloating. The main late side effects of irradiation of the small intestine are chronic diarrhea, malabsorption with steatorrhoea, abdominal spasms, intestinal obstruction, bleeding and fistulas. The architecture of the small intestine may be considered as parallel with a significant correlation between the irradiated volume of small bowel and the likelihood of acute toxicity, whatever the dose. The literature analysis recommends to consider the volume of small bowel receiving 15 Gy (threshold of 100 to 200 cm3) but also 30 and 50 Gy (thresholds of 35 to 300 cm3, depending on the level of dose considered). Modern techniques of conformal radiotherapy with modulated intensity will probably have beneficial impact on small bowel toxicity. (authors)

  18. Normal tissue tolerance to external beam radiation therapy: The vagina

    The vagina is a virtual cavity involved in sexual reproduction field. Due to its anatomical location, it may be exposed in whole or in part to ionizing radiation in external radiotherapy and/or brachytherapy of the pelvic region. This review aims to describe the vaginal acute and late side effects due to radiation, probably inadequately reported in the literature. Medline and PubMed literature searches were performed using the keywords -vaginal - radiotherapy - toxicity. The acute and late functional changes after external beam radiation consist mainly of drought. Their incidences are poorly described in the literature and the delivered doses even less. Recommendations are non-existent as the normal tissue complication probability (NTCP). Brachytherapy delivers high and heterogeneous doses, making it difficult to estimate the dose. The concomitant administration of chemotherapy appears to be a factor increasing the risk of toxicity. Modern techniques of conformal radiotherapy with modulated intensity appear to have little impact on this body. Only a maximum dose on each third of the vagina appears to be currently proposed to avoid the risk of side effects. (authors)

  19. Theoretical analysis of natural frequency of externally prestressed concrete beam based on rigidity correction

    2009-01-01

    A dynamic test on externally prestressed simply supported concrete beams separately with three typical types of tendon distributions was conducted. The results show that the natural frequencies of the beams increase with the increase in the prestressing force at the tensioning stage, and the natural frequencies decrease after the cracks occur in the beams. Following the calculation formula of natural frequency of externally prestressed beam, which was reported in a literature, the natural frequencies of the...

  20. Adjuvant radiation therapy for the treatment of endometrial cancer: experience with combination of external radiation therapy and high-dose rate brachytherapy

    Objective: To review the results of adjuvant external beam radiation therapy (EBRT) combined with high-dose rate brachytherapy (HDR-BT) for the treatment of endometrial carcinoma. Materials and methods: We retrospectively evaluated 141 patients treated with EBRT and HDR-BT after surgery between January 1993 and January 2001. EBRT was performed with a median dose of 45 Gy, and HDR-BT was performed with a median dose of 24 Gy, with four weekly insertions of 6 Gy. The median age of the patients was 63 years and the disease stage distribution was: CS I (FIGO), 52.4%; CS II, 13.5%; CS III, 29.8%; CS IV, 4.3%. Results: With a median follow-up of 53.7 months, the disease free survival (DFS) at five years was: CS I, 88.0%; CS II, 70.8%; CS III, 55.1%; CS IV, 50.0% (p = 0.0003). Global survival after five years was: CS I, 79.6%; CS II, 74.0%; CS III, 53.6%; CS IV, 100.0% (p = 0.0062). Factors affecting the DFS were histological grade and serous-papillary histology. Recurrence of the disease was observed in 33 cases, 13 (9.2%) of these occurred in the pelvis, vagina or vaginal vault. EBRT + HDR-BT of the vaginal vault allowed disease control in 90.8% of the cases. Conclusion: Radiation therapy is essential for loco-regional control of endometrial cancer and can achieve excellent cure rates in the initial stages. In more advanced stages, therapeutic failure frequently appears as distant metastases suggesting the need for complementary systemic therapy using new treatment modalities, particularly chemotherapy. (author)

  1. Combined external beam and intraluminal radiotherapy for irresectable Klatskin tumors

    Schleicher, U.M. [Klinik fuer Strahlentherapie, Technische Hochschule Aachen (Germany); Staatz, G. [Klinik fuer Radiologische Diagnostik, Technische Hochschule Aachen (Germany); Alzen, G. [Klinik fuer Radiologische Diagnostik, Technische Hochschule Aachen (Germany); Abt. Kinderradiologie, Giessen Univ. (Germany); Andreopoulos, D. [Klinik fuer Strahlentherapie, Technische Hochschule Aachen (Germany); BOC Oncology Centre, Nikosia (Cyprus)

    2002-12-01

    Background: In most cases of proximal cholangiocarcinoma, curative surgery is not possible. Radiotherapy can be used for palliative treatment. We report our experience with combined external beam and intraluminal radiotherapy of advanced Klatskin's tumors. Patients and Methods: 30 patients were treated for extrahepatic proximal bile duct cancer. Our schedule consisted for external beam radiotherapy (median dose 30 Gy) and a high-dose-rate brachytherapy boost (median dose 40 Gy) delivered in four or five fractions, which could be applied completely in twelve of our patients. 15 patients in the brachytherapy and nine patients in the non-brachytherapy group received additional low-dose chemotherapy with 5-fluorouracil. Results: The brachytherapy boost dose improved the effect of external beam radiotherapy by increasing survival from a median of 3.9 months in the non-brachytherapy group to 9.1 months in the brachytherapy group. The effect was obvious in patients receiving a brachytherapy dose above 30 Gy, and in those without jaundice at the beginning of radiotherapy (p<0.05). Conclusions: The poor prognosis in patients with advanced Klatskin's tumors may be improved by combination therapy, with the role of brachytherapy and chemotherapy still to be defined. Our results suggest that patients without jaundice should be offered brachytherapy, and that a full dose of more than 30 Gy should be applied. (orig.) [German] Hintergrund: Bei den meisten Patienten mit proximalen Cholangiokarzinomen ist eine kurative Operation nicht mehr moeglich. Im Rahmen der Palliativbehandlung kann die Strahlentherapie eingesetzt werden. Wir berichten ueber unsere Erfahrungen mit der Kombination aus perkutaner und intraluminaler Strahlentherapie fortgeschrittener Klatskin-Tumoren. Patienten und Methode: 30 Patienten wurden wegen extrahepatischer proximaler Gallengangskarzinome behandelt. Unser Therapieschema umfasste eine perkutane Strahlentherapie (mediane Dosis: 30 Gy) sowie einen

  2. External influences and priority-setting for anti-cancer agents: a case study of media coverage in adjuvant trastuzumab for breast cancer

    Fralick John

    2007-06-01

    Full Text Available Abstract Background Setting priorities for the funding of new anti-cancer agents is becoming increasingly complex. The funding of adjuvant trastuzumab for breast cancer has brought this dilemma to the fore. In this paper we review external factors that may influence decision-making bodies and present a case study of media response in Ontario, Canada to adjuvant trastuzumab for breast cancer. Methods A comprehensive search of the databases of Canadian national and local newspapers and television was performed. Articles pertaining to trastuzumab in adjuvant breast cancer as well as 17 other anti-cancer drugs and indications were retrieved. The search period was from the date when individual trial results were announced to the date funding was made available in Ontario. Results During the 2.6 months between the release of the trastuzumab results to funding approval in Ontario, we identified 51 episodes of media coverage. For the 17 other drugs/indications (7 breast and 10 non-breast, the median time to funding approval was 31 months (range 14–46. Other recent major advances in oncology such as adjuvant vinorelbine/cisplatin for resected NSCLC and docetaxel for advanced prostate cancer received considerably less media attention (17 media reports for each than trastuzumab. The median number of media reports for breast cancer drugs was 4.5 compared to 2.5 for non-breast cancer drugs (p = 0.56. Conclusion Priority-setting for novel anti-cancer agents is a complex process that tries to ensure fair use of constrained resources to fund therapies with the best evidence of clinical benefit. However, this process is subject to external factors including the influence of media, patient advocates, politicians, and industry. The data in this case study serve to illustrate the significant involvement one (or all of these external factors may play in the debate over priority-setting.

  3. Ocular complications after external-beam irradiation - a literature overview

    Radiotherapy is one of the treatment methods applied to patients suffering from head and neck cancer. The efficiency of this method is comparable to surgery, yet it allows one to save the organ and avoid its permanent deformation. In the case of radiation not only the tumour is influenced but the surrounding, normal structures as well. Radiation causes deformation of normal structures as early or side effects. The aim of this study is to present plausible ocular complications after external beam irradiation of head and neck cancer, such as radiation- induced cataract, radiation retinopathy, dry-eye syndrome or radiation neuropathy. By the use of basic principles of radiotherapy planning we can avoid or minimize possible ocular complications occurring after irradiation. The treatment of ocular complications is difficult and very often does not give the expected outcome. Therefore, in such cases in order to restore vision surgery is required. This study shows that radiotherapy can be helpful but can increase the risk of occurrence of some ocular complications. (authors)

  4. Analysis of Static and Dynamic Behavior of T-shape Beam Reinforced by External Prestressing Tendon

    Dinghai Li

    2013-01-01

    Full Text Available External prestressing has become a primary method for strengthening existing concrete beam and has been increasingly used in the construction of newly erected ones, particularly railroad bridges in recent years. In order to evaluate the effect of this method, the static and dynamic behavior of a T-frame beam reinforced by external prestressed strengthened concrete beam was analyzed by 3D finite element method, and the field test study was also made. The study was carried out to further investigate the simply supported reinforced prestressed concrete beam strengthened by external prestressing through theory analysis and experiment.

  5. Strength Modeling of Reinforced Concrete Beam with Externally Bonded FRP Reinforcement

    N. Pannirselvam; P. N. Ragunath; Suguna, K

    2008-01-01

    This research study presents the evaluation of the structural behaviour of reinforced concrete beams with externally bonded Fibre Reinforced Polymer (FRP) reinforcements. Three different steel ratios with two different Glass Fibre Reinforced Polymer (GFRP) types and two different thicknesses in each type of GFRP were used. Totally fifteen rectangular beams of 3 m length were cast. Three rectangular beams were used as reference beam (Control Beams) and the remaining were fixed with GFRP lamina...

  6. Severe dry-eye syndrome following external beam irradiation

    There are limited data in the literature on the probability of dry-eye complications according to radiotherapy dose. This study investigates the risk of radiation-induced severe dry-eye syndrome in patients in whom an entire orbit was exposed to fractionated external beam irradiation. Between October 1964 and May 1989, 33 patients with extracranial head and neck tumors received irradiation of an entire orbit. Most patients were treated with 60Co. The dose to the lacrimal apparatus was calculated at a depth of 1 cm from the anterior skin surface, the approximate depth of the major lacrimal gland. The end point of the study was severe dry-eye syndrome sufficient to produce visual loss secondary to corneal opacification, ulceration, or vascularization. Twenty patients developed severe dry-eye syndrome. All 17 patients who received dose ≥57Gy developed severe dry-eye syndrome. Three (19%) of 16 patients who received doses ≥45 Gy developed severe dry-eye syndrome; injuries in the latter group were much more slower to develop (4 to 11 years) than in the higher dose group, in whom corneal vascularization and opacification were usually pronounced within 9-10 months. There were no data for the range of doses between 45.01 and 56.99 Gy. The data did not suggest an increased risk of severe dry-eye syndrome with increasing age. Data from the current series and the literature are combined to construct a sigmoid dose response curve. The incidence of injury increases from 0% reported after doses ≥30 Gy to 100% after doses ≥57 Gy. 13 refs., 3 figs., 5 tabs

  7. Retinoblastoma: Review of 30 years' experience with external beam radiotherapy

    A review of the experience at the Peter MacCallum Cancer Centre (Peter Mac), Melbourne, Australia in treating retinoblastoma with external beam radiotherapy was conducted. Outcomes of particular interest were tumour control, vision preservation and treatment late effects. The review was restricted to patients that had intact eyes treated at Peter Mac from 1965 until 1997 with at least 2 years of follow up. Histories were reviewed regarding patient and tumour characteristics and treatment details. Thirty-five patients were identified in whom 47 eyes were treated. Of the tumours, 47% were Reese-Ellsworth stage IV or V and the majority of others were at high risk for vision loss because of tumour location. The radiation treatment technique became increasingly sophisticated during the study period. Radiation dose and fraction size have similarly evolved but most patients received 30-50 Gy. Since 1989, a highly accurate contact lens immobilization technique has been used to deliver 40 Gy in 20 fractions. Thirteen eyes required additional local therapy. Of the treated eyes, 34 (72%) remain intact and 74% of these have useful vision. One patient died from retinoblastoma and three from second malignant neoplasms. With modern radiotherapy, late toxicities other than growth arrest and non-progressive cataract did not occur during the study period. Tumour control was high and a very acceptable rate of organ and vision preservation was achieved in a relatively high-risk population. Modern radiotherapy continues to develop in an attempt to improve treatment accuracy and minimize late radiation toxicity. Copyright (2003) Blackwell Science Pty Ltd

  8. Intraoperative and external beam radiotherapy for pancreatic carcinoma; Intraoperative und perkutane Radiotherapie des Pankreaskarzinoms

    Eble, M.J. [Abt. Klinische Radiologie, Radiologische Universitaetsklinik Heidelberg (Germany); Maurer, U. [Klinikum der Stadt Mannheim (Germany). Inst. fuer Radiologie

    1996-05-01

    Therapeutic strategies in the treatment of pancreatic carcinoma are based on the high number of non-resectable cancers, the high relative radioresistance and the high distant metastases rate. Even in curatively resected carcinomas, a locally effective treatment modality is needed because of the risk of microscopical residual disease in the peripancreatic tissue. The efficacy of radiotherapy is dose dependent. Based on an analysis of published data a dose of more than 50 Gy is recommended, resulting in a high morbidity rate with external beam radiotherapy alone. The use of intraoperative radiotherapy allows locally restricted dose escalation without increased perioperative morbidity. In adjuvant and in primary treatment, local tumor control was improved (70-90%). With palliative intent, pain relief was obtained rapidly in over 60% of patients and led to improved patient performance. As a result of the high distant metastases rate, even in curatively resected carcinomas, the overall prognosis could not be significantly improved. Further dose escalation is limited by the increasing incidence of upper gastrointestinal bleeding (20-30%). (orig.) [Deutsch] Therapiestrategien beim Pankreaskarzinom werden bestimmt durch den hohen Anteil primaer nicht resektabler Karzinome, der hohen relativen Strahlenresistenz und der hohen Fernmetastasierungsrate. Selbst kurativ resezierte Karzinome erfordern durch ihre hohe lokale Tumorzellpersistenz eine lokal effektive adjuvante Behandlungsmassnahme. Die Effektivitaet einer Radiotherapie ist dosisabhaengig. Aus der Analyse publizierter Daten wird eine Dosis von >50 Gy, welche bei der alleinigen perkutanen Bestrahlung mit einer hohen Morbiditaet verbunden ist, empfohlen. Mit der intraoperativen Radiotherapie ist eine lokal begrenzte Dosiseskalation ohne erhoehte perioperative Morbiditaet moeglich. Sowohl in der adjuvanten als auch in der primaeren Behandlung kann die lokale Tumorkontrolle deutlich verbessert werden (70-90%). Unter

  9. A case of bladder cancer following adjuvant external beam radiation for prostate cancer

    A 57-year-old male with a history of right renal cell carcinoma was diagnosed with prostate carcinoma associated with a high prostatic specific antigen (PSA) level (5.2 ng/ml). Histological examination of the resected prostate specimen obtained by radical prostatectomy revealed well differentiated adenocarcinoma, Gleason score 3+3, and pT3aN0M0. After six months of observation, an elevation of PSA level was recognized and local recurrence was suspected. Therefore, radiotherapy with a total of 61.2 Gy was administered. Seventeen months later, bladder cancer was diagnosed. It had to be treated with pelvic evisceration because of suspicious heavy adhesions due to prior treatments. Histology findings were urothelial carcinoma in situ, G3, and pTisN0M0. (author)

  10. A TCP model for external beam treatment of intermediate-risk prostate cancer.

    Walsh, Seán

    2013-03-01

    Biological models offer the ability to predict clinical outcomes. The authors describe a model to predict the clinical response of intermediate-risk prostate cancer to external beam radiotherapy for a variety of fractionation regimes.

  11. Comparison Analysis of MR Images Before and After External Beam Radiotherapy in Brachytherapy

    To analyze availability of MR images before and after external beam radiotherapy in brachytherapy, we will acquire MR images before and after external beam radiotherapy and compare the change of direction of uterine cavity and analyze the accuracy of applicator insertion. From January 2009 to December 2010, we compared MR images before and after external beam radiotherapy for uterine cervical cancer only with radical purpose treatment. MR images which was acquired after external beam radiotherapy has done with inserted status of CT/MR applicator. As a consequence, the tumor was markedly reduced after external beam radiotherapy. The change of anteflexion of uterus turned into retroflexion of the uterine cavity was 17.1%. The case of wrong insertion of tandem include direction or length was 14.3%. According to MR images taken after external beam radiotherapy, we recognized not only reduced the tumor volume but the marked change of exact direction or length of the uterine cavity. So the confirmation of accurate insertion based on MR images before brachytherapy could be very helpful for optimal brachytherapy treatment planning with reduced applicator insertion errors.

  12. Filamentation instability in a light ion beam-plasma system with external magnetic field

    The filamentation instability for a light ion beam (LIB) penetrating plasma is investigated. For the stabilization of the filamentation instability, an external magnetic field which is parallel to the direction of the light ion beam propagation is applied. From a dispersion relation, linear growth rates of filamentation instabilities are obtained in a light ion beam-plasma system with an external magnetic field. Numerical simulations are carried out using a particle-in-cell (PIC) method. The stabilizing mechanism of the filamentation instability is described. The theory and simulation comparisons illustrate the results. (author)

  13. In-air RBS measurements at the LAMFI external beam setup

    Silva, T. F.; Added, N.; Moro, M. V.; Trindade, G. F.; Santos, H. C.; Rodrigues, C. L.; Rizzutto, M. A.; Tabacniks, M. H. [Institute of Physics, University of São Paulo, SP, 05508-090 (Brazil)

    2014-11-11

    This work describes new developments in the external beam setup of the Laboratory of Material Analysis with Ion Beams of the University of São Paulo (LAMFI-USP). This setup was designed to be a versatile analytical station to analyze a broad range of samples. In recent developments, we seek the external beam Rutherford Backscattering Spectroscopy (RBS) analysis to complement the Particle Induced X-ray Emission (PIXE) measurements. This work presents the initial results of the external beam RBS analysis as well as recent developments to improve the energy resolution RBS measurements, in particular tests to seek for sources of resolution degradation. These aspects are discussed and preliminary results of in-air RBS analysis of some test samples are presented.

  14. Radiation signatures from an external relativist electron beam

    Wee, Kyoum Bok

    1988-01-01

    X-band radiation has been observed which occurs when an electron beam travelling in air traverses an aluminum plate. The radiation pattern is more complicated than can be explained with a simplified model of Cerenkov radiation from air and transition radiation from the aluminum-air interface. The empirical observation is that the peak angle decreases with energy until about 70 MeV, then increases with energy. The angular width of the peak distribution shows a similar behavior with energy. The...

  15. Microwave radiation power of relativistic electron beam with virtual cathode in the external magnetic field

    Kurkin, S. A.; Hramov, A. E.; Koronovskii, A. A.

    2013-07-01

    The study of the output power of the electromagnetic radiation of the relativistic electron beam (REB) with virtual cathode in the presence of external magnetic field has been found out. The typical dependencies of the output microwave power of the vircator versus external magnetic field have been analyzed by means of 3D electromagnetic simulation. It has been shown that the power of vircator demonstrates several maxima with external magnetic field growth. The characteristic features of the power behavior are determined by the conditions of the virtual cathode formation in the presence of the external transversal magnetic field and the REB self-magnetic fields.

  16. Microwave radiation power of relativistic electron beam with virtual cathode in the external magnetic field

    Kurkin, S. A.; Hramov, A. E.; Koronovskii, A. A. [Saratov State University, Astrakhanskaja 83, Saratov 410012 (Russian Federation); Saratov State Technical University, Politechnicheskaja 77, Saratov 410028 (Russian Federation)

    2013-07-22

    The study of the output power of the electromagnetic radiation of the relativistic electron beam (REB) with virtual cathode in the presence of external magnetic field has been found out. The typical dependencies of the output microwave power of the vircator versus external magnetic field have been analyzed by means of 3D electromagnetic simulation. It has been shown that the power of vircator demonstrates several maxima with external magnetic field growth. The characteristic features of the power behavior are determined by the conditions of the virtual cathode formation in the presence of the external transversal magnetic field and the REB self-magnetic fields.

  17. Strength Modeling of Reinforced Concrete Beam with Externally Bonded FRP Reinforcement

    N. Pannirselvam

    2008-01-01

    Full Text Available This research study presents the evaluation of the structural behaviour of reinforced concrete beams with externally bonded Fibre Reinforced Polymer (FRP reinforcements. Three different steel ratios with two different Glass Fibre Reinforced Polymer (GFRP types and two different thicknesses in each type of GFRP were used. Totally fifteen rectangular beams of 3 m length were cast. Three rectangular beams were used as reference beam (Control Beams and the remaining were fixed with GFRP laminates on the soffit of the rectangular beam. The variables considered for the study includes longitudinal steel ratio, type of GFRP laminates, thickness of GFRP laminates and composite ratios. Flexural test, using simple beam with third-point loading was adopted to study the performance of FRP plated beams interms flexural strength, deflection, ductility and was compared with the unplated beams. The test results show that the beams strengthened with GFRP laminates exhibit better performance. The flexural strength and ductility increase with increase in thickness of GFRP plate. The increase in first crack loads was up to 88.89% for 3 mm thick WRGFRP plates and 100.00% for 5 mm WRGFRP plated beams and increase in ductility interms of energy and deflection was found to be 56.01 and 64.69% respectively with 5 mm thick GFRP plated beam. Strength models were developed for predicting the flexural strength (ultimate load, service load and ductility of FRP beams. The strength model developed give prediction matching the measurements.

  18. A quality audit program for external beam radiotherapy

    Hanson, W.F.; Stovall, M. [Univ. of Texas, Houston, TX (United States)

    1993-12-31

    For more than 25 years, the University of Texas M. D. Anderson Cancer Center has had a quality audit program using mailed dosimeters to verify radiation therapy machine output. Two programs, one compulsory and one voluntary, presently monitor therapy beams at more than 1000 megavoltage-therapy facilities. A successful program requires two major components: a high-precision thermoluminescent dosimeter (TLD) system and dedicated staff that interact closely with the users to resolve discrepancies. The TLD system, the logistics used, and the human interaction of these programs are described. Examples show that the programs can identify major discrepancies, exceeding 5 %, as well as discrepancies as small as 3%.

  19. Externalities

    Verhoef Erik T.

    1997-01-01

    This paper discusses the concept of ‘externalities ‘. It starts with a brief discussion of market failures in the neoclassical economic framework. It then proceeds to a definition of externalities, thereby distinguishing external effects from other sorts of ‘unpriced effects ‘. Finally, some attention is paid to the relation, and tension, between efficiency and equity impacts of externalities.

  20. Dysprosium detector for neutron dosimetry in external beam radiotherapy

    Radiotherapy treatments with high-energy (>8MeV) photon beams are a standard procedure in clinical practice, given the skin and near-target volumes sparing effect, the accurate penetration and the uniform spatial dose distribution. On the other hand, despite these advantages, neutrons may be produced via the photo-nuclear (γ,n) reactions of the high-energy photons with the high-Z materials in the accelerator head, in the treatment room and in the patient, resulting in an unwanted dose contribution which is of concern, given its potential to induce secondary cancers, and which has to be monitored. This work presents the design and the test of a portable Dysprosium dosimeter to be used during clinical treatments to estimate the “in vivo” dose to the patient. The dosimeter has been characterized and validated with tissue-equivalent phantom studies with a Varian Clinical iX 18 MV photon beam, before using it with a group of patients treated at the S. Anna Hospital in Como. The working principle of the dosimeter together with the readout chain and the results in terms of delivered dose are presented

  1. EXTERNAL PRESTRESSING OF RC T-BEAMS WITH CFRP TENDONS

    Bennitz, Anders; Schmidt, Jacob Wittrup; Täljsten, Björn

    2009-01-01

    stated in [6] and future guidelines, a database of tested structures to compare with is necessary. Such a database is for example used in [7] for verification of FRP shear strengthening models and is in that case composed of more than 200 tested beams with different material and geometrical properties...... ultimate capacity could be increased, with a carefully applied compressive stress existing open cracks in concrete may be partly closed and it might also be possible to reduce large deflections. In that way the durability of the entire RC (Reinforced Concrete) -structure can be increased. Application of...... FRPs as prestressing materials does however require a new design philosophy. FRPs are in contradiction to high strength prestressing steel linearly elastic until failure and they are, in their nature, also generally orthotropic. The behaviour of a RC-structure prestressed with FRP might therefore...

  2. System design for strengthening simply supported RC beams in flexure by retrofitting external unbonded conventional reinforcement

    The paper presents the practical design approach and guidelines for the system design of a novel strengthening technique where external unbounded ordinary reinforcement is retrofitted to reinforced concrete beams for enhancement of flexural capacity of simply supported and cantilever beams of buildings and bridges. The design guidelines for the system hardware along with the practical consideration in applications have been elaborately presented. Suitable design examples have been included demonstrating the suitability of the technique in comparison to steel plate bonding. Strengthening with external unbounded reinforcement has been shown to provide an appreciable increase in the ultimate flexural strength of reinforced concrete beams. Additionally the technique offers greater simplicity and ease of installation in comparison to other widely used strengthening techniques, such as shotcrete with additional tension reinforcement, epoxy bonded steel plates and external unbounded prestressing tendors, where less stringent requirements for deflectors, anchorage and end zones are encountered. (author)

  3. Characterization of mercury gilding art objects by external proton beam

    The fire gilding is one of the methods used by the ancient goldsmiths to obtain a rich, metallic glow and durable golden appearance in ornamental objects. This layer is characterized, among others, by its thickness (several microns) a diffusion profile and a Hg content (between 0 and 21 wt.%) depending on the temperatures achieved during the process. Gilded sacral art objects dated from the XVI to the XVIII centuries, belonging to the Casa-Museu Dr. Anastácio Gonçalves Collection (Lisbon) were analyzed using the external ion microprobe at Nuclear and Technological Institute, Lisbon. The average concentrations of the homogeneous areas were calculated with GUPIX, DATTPIXE and NDF codes showing very similar results. The RBS and PIXE spectra from the same point were collected simultaneously and analyzed together with NDF-LibCPIXE in order to find self-consistent solutions. Profile concentration on particular Au-reach points was extracted. Different Hg and Au/Ag ratio have been found in the pieces dating from different centuries.

  4. External beam monitoring of the Cyclone 30 cyclotron of IPEN-CNEN-SP

    Due to the increasing demand for cyclotron radioisotopes and the high cost of equipment and materials involved in the process, it becomes evident the importance of external beam monitoring of the cyclotron. In this way, the beam of the Cyclone 30 cyclotron of IPEN-CNEN/S P was characterized throughout the evaluation of its current intensity, profile (position, focus and geometry), alignment and homogeneity, by measuring currents, temperatures and pressures of irradiation systems. For this purpose, techniques and conventional devices, thermocouples and pressure sensors associated to electronic of instrumentation, and technology and flexibility of micro controllers allowed observing the beam behavior during irradiations in real time. The ion beam energy was also evaluated using activation analysis technique of monitor reactions in natCu. The beam monitoring systems have been contributing to prevent material damages and they have already been used in routine irradiations, bringing important advantages in the process of beam optimization of the Cyclone 30. (author)

  5. Bond strength of short lap splices in RC beams confined with steel stirrups or external CFRP

    Garcia, R.; Helal, Y.; Pilakoutas, K.; GUADAGNINI, M

    2015-01-01

    This paper investigates the bond behaviour of lapped steel bars using fifteen RC beams tested in flexure. Twelve of the beams were designed to fail by bond splitting at midspan, where the main flexural reinforcement was lapped 10 bar diameters. The parameters studied include the amount and type of confinement at midspan (no confinement, internal steel stirrups or externally bonded carbon FRP), concrete cover and bar size. The results show that the CFRP confinement enhanced the bond strength o...

  6. Oral 2.01: Proton beam radiation therapy for adjuvant and definitive treatment of thymoma and thymic carcinoma

    Vogel, Jennifer H.; Berman, Abigail T.; Pechet, Taine T.; William, Levin P.; Gabriel, Peter E.; Khella, Sami; Singhal, Sunil; Kucharczuk, John C.; Simone, Charles B.

    2015-01-01

    Background Radiation therapy is a critical component of treatment for thymic tumors. However, radiation-induced toxicity may reduce benefit, particularly in the adjuvant setting. Proton beam therapy (PBT), due to its characteristic Bragg peak, is ideally suited to treat the anterior mediastinum while sparing organs at risk. To date, PBT to treat thymic tumors has only been reported in three single-patient case studies. In this study, we evaluated patterns of failure and toxicity in patients treated for thymoma and thymic carcinoma using PBT and hypothesized that PBT can achieve excellent local control with limited high grade toxicity. Methods All patients with thymoma or thymic carcinoma treated with PBT between 2011–2015 were analyzed. Either double scattered proton therapy (DS-PT) or pencil beam scanning (PBS) were used. Toxicity was assessed using CTCAE v 4.2. Local control, distant control, and overall survival were analyzed by the Kaplan-Meier method from the time of PBT completion. Results Twenty-seven patients were included. Patients were a median age of 56 years, predominantly female (56%), and had thymoma (85%) or thymic carcinoma (15%). They were treated with definitive (22%) or salvage (15%) PBT or adjuvant (63%) PBT following resection with predominantly close (23%) or positive (50%) margins. Forty-one percent also received chemotherapy. Patients were treated to a median of 61.2 Gy (range 50.4–70.2 Gy) using DS-PT (85%) or PBS (15%). Median mean lung dose, volume of lung receiving ≥20 Gy (V20), and V5 were 98 cGy (1–2,050 cGy), 18% (0–38%), and 26.2% (0–55%). Median mean heart and esophagus doses were 1,065 cGy (105–3,356cGy) and 1,072cGy (0–4,655 cGy). No patient experienced grade ≥3 acute or chronic toxicity. Acute grade ≥2 toxicities included fatigue (11%), esophagitis (7%), dermatitis (37%), and pneumonitis in one patient (4%) who received 2 prior thoracic radiotherapy courses. Late grade ≥2 toxicity was limited to a single

  7. Quality assurance network in central Europe. External audit on output calibration for photon beams

    The EROPAQ project for TLD monitoring of photon beams started in June 1994 with the set-up of the TLD system: calibration, reading and evaluation procedures. The acceptance level of ±3% was set for the TLD intercomparisons. The policy of the project was to check all beams in 47 participating radiotherapy centres and to recheck all the beams in those centres, where a deviation exceeding ±3% occurred in one or more of the beams. Out of 129 beams checked, 100 beams (78%) were found within the ±3% limit. Eleven beams show deviations larger than ±6%, and immediate corrective action was undertaken. Out of 47 centres checked, 22 did not participate in any external audit in a preceding 5 years. In these centres 68% (34/50) of the total number of γ and X-ray beams checked but only 59% (20/34) of γ beams were within the acceptance level, while in the 25 centres, which participated in an external audit before, these figures were 84% (66/79) and 88% (35/40) respectively. The sources of discrepancies were thoroughly investigated, discussed with the participants and the errors corrected. Poor results were in several cases associated with very old design of radiotherapy units and old dosimetry systems, equipped with inadequate ionization chambers. In several centres, an insufficient training of the physicists in clinical dosimetry was observed. Thanks to the corrective action, a great improvement of calibration of the beams was achieved. Standard deviation of the distribution of the results for all x and γ beams checked decreased from SD = 7.4% at the first check to SD = 2.5% at the second check. (orig.)

  8. Quality assurance network in Central Europe: External audit on output calibration for photon beams

    The EROPAQ project for TLD audit of photon beams in radiotherapy centres of Czech Republic, Hungary and Poland started in June 1994. The acceptance level of ±3% was set for the TLD intercomparisons. The policy of the project was to check all beams in 47 participating radiotherapy centres and to recheck all the beams in those centres, where a deviation exceeding ±3% occurred in one or more of the beams. Out of 129 beams checked, 100 beams (78%) were found within the ±3% limit. Eleven beams show deviations larger than ±6%, and immediate corrective action was undertaken. Out of 47 centres checked, 22 did not participate in any external audit in a preceding 5 years. In these centres 68% ((34(50))) of the total number of γ and X-ray beams checked but only 59% ((20(34))) of γ beams were within the acceptance level, while in the 25 centres, which participated in an external audit before, these figures were 84% ((66(79))) and 88% ((35(40))), respectively. The sources of discrepancies were investigated, discussed with the participants and the errors corrected. Poor results were in several cases associated with very old design of radiotherapy units and old dosimetry systems, equipped with inadequate ionization chambers. In several centres, an insufficient training of the physicists in clinical dosimetry was observed. Thanks to the corrective action, a great improvement of calibration of the beams was achieved. Standard deviation of the distribution of the results for all X and γ beams checked decreased from SD = 7.4% in the first check to SD = 2.5% in the second check

  9. Shear Strength of Reinforced Concrete Beam Strengthened by Transverse External Post-tension

    Sayan Sirimontree

    2011-01-01

    Full Text Available Problem statement: Shear failure of concrete beam is brittle manner without warning so inadequate design for shear of beam and/or material deterioration lead to the possibility of sudden failure of beam. The change of functional use and future increased load of structure lead to the need for strengthening of concrete structure. Approach: This research focuses on behaviors under static loading of reinforced concrete beam, with shear strengthening by transverse external prestressing force. Post-tension high strength steel is vertically applied in shear span. Total eight beam specimens are divided into two groups each having shear span to depth ratios 2 and 1.5. Each beam, possessing the same reinforcing steels, is intentionally designed to be failing in shear. One of the beams from each group is used as reference, without shear strengthening. The other three specimens from each group are applied different amounts of external prestressing force. Results: The experimental result shows that ultimate load carrying capacity of all shear strengthened specimens significantly improves over the reference specimen. The higher the amount of applied strengthening force, the greater the ability to carry ultimate loading. Failure mode shifts from brittle shear failure closer to ductile flexural failure, with higher ductility and stiffness. External prestressing force in transverse direction of shear span of beam enhances ultimate shear capacity by improving aggregate interlocking, preventing splitting cracks caused by debonding of longitudinal reinforcing steels due to dowel action. Furthermore, load at first diagonal tension cracks are increased as a result of pre-compressed prestressing force leading to the higher ultimate load carrying capacity. Moreover, concrete in compression zone remains uncrushed at ultimate state. Strut-and-tie model can be used to predict ultimate loading capacity of beam specimen and failure mechanism of both

  10. Implementation of a system for external audits beam radiation therapy in terms of reference no

    This paper presents our experience in implementing a external audit system for radiotherapy beam in no reference conditions with the use of CIRS and a summary of the measurements with him made.This paper presents our experience in implementing a external audit system for radiotherapy beam in no reference conditions with the use of CIRS and a summary of the measurements with him made. Centers were audited with external beam high-energy Co-60, 6 MV and 15 MV and were considered 4 treatment planning systems (TPS): AMEPLAN, Theraplan Plus, Precise Plan and MIRS to calculate doses prescribed in each test case. All measurements were acquired by the audit team using the anthropomorphic phantom CIRS, Semiflex chamber PTW 31010 and PTW electrometer STATES. The implementation and development of the external audits of beams radiotherapy in terms of 'no reference' has brought an improvement in both clinical aspects of treatment and the radiation safety and the quality control, has given us greater confidence and for this reason we believe has become essential. (Author)

  11. Reinforced concrete T-beams externally prestressed with unbonded carbon fiber-reinforced polymer tendons

    Bennitz, Anders; Nilimaa, Jonny; Ravn, Dorthe Lund;

    2012-01-01

    This study describes a series of experiments examining the behavior of seven beams prestressed with unbonded external carbon fiberreinforced polymer (CFRP) tendons anchored using a newly developed anchorage and post-tensioning system. The effects of varying the initial tendon depth, prestressing ...

  12. Reinforced concrete T-beams externally prestressed with unbonded carbon fiber-reinforced polymer tendons

    Bennitz, Anders; Nilimaa, Jonny; Ravn, Dorthe Lund; Schmidt, Jacob W.; Täljsten, Björn; Goltermann, Per

    2012-01-01

    This study describes a series of experiments examining the behavior of seven beams prestressed with unbonded external carbon fiberreinforced polymer (CFRP) tendons anchored using a newly developed anchorage and post-tensioning system. The effects of varying the initial tendon depth, prestressing...... force, and the presence of a deviator were investigated. The results were compared to those observed with analogous beams prestressed with steel tendons, common beam theory, and predictions made using an analytical model adapted from the literature. It was found that steel and CFRP tendons had very...... similar effects on the structural behavior of the strengthened beams; the minor differences that were observed are attributed to the difference between the modulus of elasticity of the CFRP and the steel used in the tests. The models predicted the beams' load-bearing behavior accurately but were less...

  13. External beam radiation for retinoblastoma: Results, patterns of failure, and a proposal for treatment guidelines

    Purpose: To analyze treatment results and patterns of failure following external beam radiation for retinoblastoma and propose treatment guidelines according to specific clinical variables. Methods and Materials: We analyzed 27 patients (34 eyes) with retinoblastoma who received external beam radiation as initial treatment at Hahnemann University Hospital from October 1980 to December 1991 and have been followed for at least 1 year. Of the 34 eyes, 14 were Groups I-II (Reese-Ellsworth classification), 7 were Group III, and 13 were Groups IV-V. Doses ranged from 34.5-49.5 Gy (mean 44.3 Gy, median 45 Gy) in 1.5-2.0 Gy fractions generally delivered through anterior and lateral wedged pair fields. Results: At a mean follow up of 35.2 months (range 12-93 months), local tumor control was obtained in 44% (15 out of 34) of eyes with external beam radiation alone. Salvage therapy (plaque brachytherapy, cryotherapy, and/or photocoagulation) controlled an additional 10 eyes (29.5%), so that overall ocular survival has been 73.5%. Local tumor control with external beam radiotherapy alone was obtained in 78.5% (11 out of 14) of eyes in Groups I-II, but in only 20% (4 out of 20) of eyes in Groups III-V. A total of 67 existing tumors were identified prior to treatment in the 34 treated eyes and local control with external beam radiation alone was obtained in 87% (46 out of 53) of tumors measuring 15 mm or less and in 50% (7 out of 14) of tumors measuring more than 15 mm. When analyzing patterns of failure in the 19 eyes that relapsed, a total of 28 failure sites were identified and consisted of progression of vitreous seeds in seven instances (25% of failure sites) recurrences from previously existing tumors in 10 instances (36% of failure sites) and development of new tumors in previously uninvolved retina in 11 instances (39% of failure sites). Conclusions: 1) We find that external beam radiation to a dose of 45 Gy in fractions of 1.5 to 2.0 Gy provides adequate tumor control

  14. External beam radiation therapy and retinoblastoma: Long-term results in the comparison of two techniques

    Purpose: This study compares the long-term actuarial local control, eye conservation rate, survival, and ocular complications in children with retinoblastoma treated with two different external beam treatment techniques. Methods and Materials: From 1979-1991, 182 eyes in 123 children (104 bilateral) received primary external beam radiation therapy. An anterior lens-sparing electron beam technique delivering 38 to 50 Gy in 2.5 Gy fractions was used in 67 eyes from 1979-1984 and a modified lateral beam technique, delivering 42 to 46 Gy in 2 Gy fractions, was used in 113 eyes from 1984-1991. These groups were balanced with respect to known prognostic variables. Results: For Group I-III eyes, the 5- and 8-year local control was significantly improved using the modified lateral beam technique (84%) compared to (38%) using the anterior lens sparing technique (p p ≤ 0.0001). For Group IV-V eyes, the 5- and 8-year local control rates were not statistically different, despite a trend favoring the modified lateral beam technique. Survival endpoints including eye survival (no enucleation), cause-specific survival, and overall survival comparing the two treatment techniques were not significantly different. Overall, 22% of eyes developed cataracts. There was no difference between the two treatment groups in terms of cataract development. No eyes required enucleation for ocular complications. Conclusion: There is a significant improvement in local control using the modified lateral beam technique compared to an anterior lens-sparing approach for Group I-III eyes. However, there was no difference in survival end points between the two treatment techniques. The incidence of ocular complications using these two external beam techniques is acceptable.

  15. Flexural Behavior of RC Members Using Externally Bonded Aluminum-Glass Fiber Composite Beams

    Ki-Nam Hong

    2014-03-01

    Full Text Available This study concerns improvement of flexural stiffness/strength of concrete members reinforced with externally bonded, aluminum-glass fiber composite (AGC beams. An experimental program, consisting of seven reinforced concrete slabs and seven reinforced concrete beams strengthened in flexure with AGC beams, was initiated under four-point bending in order to evaluate three parameters: the cross-sectional shape of the AGC beam, the glass fiber fabric array, and the installation of fasteners. The load-deflection response, strain distribution along the longitudinal axis of the beam, and associated failure modes of the tested specimens were recorded. It was observed that the AGC beam led to an increase of the initial cracking load, yielding load of the tension steels and peak load. On the other hand, the ductility of some specimens strengthened was reduced by more than 50%. The A-type AGC beam was more efficient in slab specimens than in beam specimens and the B-type was more suitable for beam specimens than for slabs.

  16. Last ICRU recommendations for the prescription, recording and reporting of external beam therapy

    Due to the evolution of radio-therapy techniques and equipments, in 1993 the ICRU decided to modify the guidelines that had been published in the ICRU Report 29 (1978) in regard to photon beam therapy and to insert them in Report number 50 (1993). Changes that were introduced mainly concerned the prescription, recording and reporting of external beam therapy with photons. While awaiting for the upcoming publication of the report focusing on external beam therapy with electrons, the ICRU decided to publish a supplement to Report 50, as new insights had been gained after discussions with the Nordic Association of Clinical Physicists (NACP). This supplement includes the following: more accurate definitions of the margins allowing the planned target volume to be derived from the clinical target volume, the internal target volume, the expected volume of organs at-risk and the conformity index. All three points will be electrons as well new recommendations. (author)

  17. Chaotic oscillations in electron beam with virtual cathode in external magnetic field

    Hramov, A. E.; Koronovskiy, A. A.; Kurkin, S. A.; Rempen, I. S.

    2011-11-01

    This article presents the results of a numerical study of external magnetic field influence on the conditions and mechanisms of virtual cathode (VC) formation in a relativistic electron beam. It also considers other related issues, e.g. peculiarities of nonlinear dynamics of electron beam with VC under changed external magnetic field, different mechanisms of VC oscillation chaotisation leading to complication of vircator system dynamics and appearance of multi-frequency VC oscillations. General systemic mechanism of VC oscillation chaotisation has been identified which is connected with formation of electronic patterns in electron beam whose interaction in the common field of spatial charge determines appearance of additional inner feedback. Transition from chaotic to periodical oscillation regime is found to be connected with destroying the mechanism of secondary electronic structures (electron bunches) formation. Besides, the influence of extent of screening of electron gun from magnetic field is discussed.

  18. The relationship between external beam radiotherapy dose and chronic urinary dysfunction - A methodological critique

    Purpose: To perform a methodological critique of the literature evaluating the relationship between external beam radiotherapy dose/volume parameters and chronic urinary dysfunction to determine why consistent associations between dose and dysfunction have not been found. Methods and materials: The radiotherapy literature was reviewed using various electronic medical search engines with appropriate keywords and MeSH headings. Inclusion criteria comprised of; English language articles, published between 1999 and June 2009, incorporating megavoltage external beam photons in standard-sized daily fraction. A methodological critique was then performed, evaluating the factors affected in the quantification of radiotherapy dose and chronic urinary dysfunction. Results: Nine of 22 eligible studies successfully identified a clinically and statistically significant relationship between dose and dysfunction. Accurate estimations of external beam radiotherapy dose were compromised by the frequent use of dosimetric variables which are poor surrogates for the dose received by the lower urinary tract tissue and do not incorporate the effect of daily variations in isocentre and bladder position. The precise categorization of chronic urinary dysfunction was obscured by reliance on subjective and aggregated toxicity metrics which vary over time. Conclusions: A high-level evidence-base for the relationship between external beam radiotherapy dose and chronic urinary dysfunction does not currently exist. The quantification of the actual external beam dose delivered to the functionally important tissues using dose accumulation strategies and the use of objective measures of individual manifestations of urinary dysfunction will assist in the identification of robust relationships between dose and urinary dysfunction for application in widespread clinical practice.

  19. Strengthening of RC Beams Using Externally Bonded Reinforcement Combined with Near-Surface Mounted Technique

    Kh Mahfuz ud Darain

    2016-07-01

    Full Text Available This study investigates the flexural behaviour of reinforced concrete (RC beams strengthened through the combined externally bonded and near-surface mounted (CEBNSM technique. The externally bonded reinforcement (EBR and near-surface mounted (NSM techniques are popular strengthening solutions, although these methods often demonstrate premature debonding failure. The proposed CEBNSM technique increases the bond area of the concrete–carbon fibre reinforced polymer (CFRP interface, which can delay the debonding failure. This technique is appropriate when any structure has a narrow cross-sectional width or is in need of additional flexural capacity that an individual technique or material cannot attain. An experimental test matrix was designed with one control and five strengthened RC beams to verify the performance of the proposed technique. The strengthening materials were CFRP bar as NSM reinforcement combined with CFRP fabric as EBR material. The test variables were the diameter of the NSM bars (8 and 10 mm, the thickness of the CFRP fabrics (one and two layers and the U-wrap anchorage. The strengthened beams showed enhancement of ultimate load capacity, stiffness, cracking behaviour, and strain compatibility. The ultimate capacity of the CEBNSM-strengthened beams increased from 71% to 105% compared to that of the control beam. A simulation method based on the moment-rotation approach was also presented to predict the behaviour of CEBNSM-strengthened RC beams.

  20. Squamous cell carcinoma of the anal canal: treatment by external beam irradiation

    External beam radiation therapy alone or in combination with curietherapy is the recommended treatment for anal canal carcinoma in some countries. In others, surgery is the sole accepted treatment. The results for 64 patients treated by external radiotherapy alone show excellent survival for stage T1T2 tumors but results are poor for large tumors (stage T4). Complications follow radiotherapy more frequently in those with stage T3 and T4 tumors. The analysis of local recurrences, complications and survival shows that radiation therapy may be sufficient treatment for stage T1 and T2 and for some stage T3 tumors. The importance of anal sphincter involvement and the poor quality of life for patients who are cured but develop complications, shows the need for combined treatment with surgery and perhaps with chemotherapy. For small tumors the results obtained by external radiotherapy alone are comparable with those obtained by external radiotherapy and curietherapy in terms of survival and complications. (Auth.)

  1. Beam-centric algorithm for pretreatment patient position correction in external beam radiation therapy

    Purpose: In current image guided pretreatment patient position adjustment methods, image registration is used to determine alignment parameters. Since most positioning hardware lacks the full six degrees of freedom (DOF), accuracy is compromised. The authors show that such compromises are often unnecessary when one models the planned treatment beams as part of the adjustment calculation process. The authors present a flexible algorithm for determining optimal realizable adjustments for both step-and-shoot and arc delivery methods. Methods: The beam shape model is based on the polygonal intersection of each beam segment with the plane in pretreatment image volume that passes through machine isocenter perpendicular to the central axis of the beam. Under a virtual six-DOF correction, ideal positions of these polygon vertices are computed. The proposed method determines the couch, gantry, and collimator adjustments that minimize the total mismatch of all vertices over all segments with respect to their ideal positions. Using this geometric error metric as a function of the number of available DOF, the user may select the most desirable correction regime. Results: For a simulated treatment plan consisting of three equally weighted coplanar fixed beams, the authors achieve a 7% residual geometric error (with respect to the ideal correction, considered 0% error) by applying gantry rotation as well as translation and isocentric rotation of the couch. For a clinical head-and-neck intensity modulated radiotherapy plan with seven beams and five segments per beam, the corresponding error is 6%. Correction involving only couch translation (typical clinical practice) leads to a much larger 18% mismatch. Clinically significant consequences of more accurate adjustment are apparent in the dose volume histograms of target and critical structures. Conclusions: The algorithm achieves improvements in delivery accuracy using standard delivery hardware without significantly increasing

  2. Influence of external beam technique and brachytherapy quality assurance on the side effects in the combined external beam- and brachytherapy treatment of local advanced prostate cancer

    Transrectal ultrasound(TRUS) guided HDR implantation of the prostate has been established at the Kiel University by Bertermann and Brix in 1986 and there are to date 179 (T1b-T3 No Mo) patients treated in a combined modality. The dose for the implant was 2x 15 Gy on the capsule of the prostate in 14-20 days. For local and regional lymph nodes 20 Gy external beam therapy (AP-PA pelvic portals), 20 Gy with an individual transmission block (100% for subclinical disease, 70% and 50% according to the implant dosimetry for the prostate) and 10 Gy small volume irradiation for the prostate was applied, conventional fractioned. Total dose after the therapy 70 Gy for the prostate and 50 Gy for the subclinical disease in 6-7 weeks. As a quality control method we use since 1991 in vivo dosimetry on the medial rectum wall as well as in the prostatic part of the urethra. Regular follow-up 3-118 months after therapy (median 55) with PSA, digital rectal examination, control TRUS with volumetry (after one year with biopsy) and bone scan. There were no major early side effects within the first three months. Proctitis till 1991 with a duration up to 12 months 49%, prolonging more than one year in 23 %, (total proctitis 72.6%). Dysuria in up to 12 months 30 %, long lasting 30% (total number of dysuria 60 %). Erectile dysfunction in 56 %. Because of the number of the side effects 1991 we changed the external beam technique: instead of the biaxial arch therapy the AP-PA portals, and reduced irradiated volume (from 6480 cm3 to 5040 cm3). We introduced instead of the small volume arch therapy for 10 Gy external boost the box-technique with shielding the back part of the rectum and the upper part of the bladder resulting additional volume reduction. Through the 15 Gy HDR brachytherapy dose on the prostate capsule there are up to 8 Gy on the medial rectal wall, measured by in vivo dosimetry. This dose could not be responsible for the high number of side effects (see gynecological experience

  3. The new external beam facility of the Oxford scanning proton microprobe

    This paper describes the development of a high spatial resolution external beam facility on one of the beamlines of the Oxford scanning proton microprobe tandem accelerator. Using a magnetic quadrupole doublet to focus the beam through the Kapton exit window a beam diameter of <50 μm full width at half maximum (fwhm) can be achieved on a sample located at 4 mm from the exit window. The facility is equipped with two Si-Li X-ray detectors for proton-induced X-ray emission (PIXE) analysis of light and trace elements respectively, a surface barrier detector for Rutherford backscattering spectrometry (RBS) analysis and a HP-Ge detector for γ-ray detection. The mechanical and beam-optical design of the system is described

  4. Place and technical aspects of external beam radiation therapy in the treatment of adult soft tissue sarcomas; Place et techniques de radiotherapie dans le traitement des sarcomes des tissus mous de l'adulte

    Le Pechoux, C.; Roberti, E.; Habrand, J.L. [Institut Gustave-Roussy, Dept. de Radiotherapie, 94 - Villejuif (France); Bonvalot, S.; Missenard, G. [Institut Gustave-Roussy, Dept. de Chirurgie, 94 - Villejuif (France); Le Cesne, A. [Institut Gustave-Roussy, Dept. de Medecine, 94 - Villejuif (France); Vanel, D. [Institut Gustave-Roussy, Dept. de Radiologie, 94 - Villejuif (France); Terrier, Ph. [Institut Gustave-Roussy, Dept. d' Anatomopathologie, 94 - Villejuif (France); Bonvalot, S.; Le Pechoux, C.; Le Cesne, A.; Roberti, E.; Vanel, D.; Terrier, Ph.; Missenard, G. [Institut Gustave-Roussy, Comite Sarcome, 94 - Villejuif (France)

    2006-02-15

    In soft tissue sarcoma, surgical resection remains the cornerstone of therapy for localized disease. Quality of margins is very important evaluate. In case of marginal or incomplete resection, a new enlarged surgical resection should always be discussed before administration of an adjuvant treatments. Many retrospective studies and 2 randomized studies (one of adjuvant brachytherapy and one of external beam radiotherapy) have shown that adjuvant radiotherapy after complete surgery reduces significantly the risk of local recurrence in extremity soft tissue sarcomas. Combination of surgery and pre- or postoperative radiotherapy has therefore become the standard treatment with a local recurrence rate {<=} 25 % and very few amputations. A recent randomized study has compared pre-op to postoperative radiotherapy. The results in terms of local control are similar in both arms (93 and 92% at 5 years) but the risk of early complications is higher in the preoperative arm and the risk of late sequela is higher in the postoperative arm. Surgical resection without radiotherapy may be considered after discussion at best within a multidisciplinary meeting, if surgical margins are considered satisfactory, in superficial, small tumours and low-grade. In retroperitoneal sarcomas, adjuvant radio-therapy is not a standard. It may decrease the risk of local recurrence but at the price of an increased gastro-intestinal toxicity. A randomized trial is warranted. Because of its rarity, and the risk of recurrence both local and metastatic, treatment should preferentially be discussed with a multimodality specialized approach. (author)

  5. Development of an external beam nuclear microprobe on the Aglae facility of the Louvre museum

    Calligaro, T.; Dran, J.-C. E-mail: dran@culture.fr; Ioannidou, E.; Moignard, B.; Pichon, L.; Salomon, J

    2000-03-01

    The external beam line of our facility has been recently equipped with the focusing system previously mounted on a classical nuclear microprobe. When using a 0.1 {mu}m thick Si{sub 3}N{sub 4} foil for the exit window and flowing helium on the sample under analysis, a beam spot as small as 10 {mu}m is attainable at a distance of 3 mm from the window. Elemental micromapping is performed by mechanical scanning. An electronic device has been designed which allows XY scanning by moving the sample under the beam by steps down to 0.1 {mu}m. Beam monitoring is carried out by means of the weak X-ray signal emitted by the exit foil and detected by a specially designed Si(Li) detector cooled by Peltier effect. The characteristics of external beams of protons and alpha particles are evaluated by means of resonance scanning and elemental mapping of a grid. An example of application is presented, dealing with elemental micro-mapping of inclusions in gemstones.

  6. Development of an external beam nuclear microprobe on the Aglae facility of the Louvre museum

    Calligaro, T.; Dran, J.-C.; Ioannidou, E.; Moignard, B.; Pichon, L.; Salomon, J.

    2000-03-01

    The external beam line of our facility has been recently equipped with the focusing system previously mounted on a classical nuclear microprobe. When using a 0.1 μm thick Si 3N 4 foil for the exit window and flowing helium on the sample under analysis, a beam spot as small as 10 μm is attainable at a distance of 3 mm from the window. Elemental micromapping is performed by mechanical scanning. An electronic device has been designed which allows XY scanning by moving the sample under the beam by steps down to 0.1 μm. Beam monitoring is carried out by means of the weak X-ray signal emitted by the exit foil and detected by a specially designed Si(Li) detector cooled by Peltier effect. The characteristics of external beams of protons and alpha particles are evaluated by means of resonance scanning and elemental mapping of a grid. An example of application is presented, dealing with elemental micro-mapping of inclusions in gemstones.

  7. Active Vibration Control of a Nonlinear Beam with Self- and External Excitations

    J. Warminski

    2013-01-01

    Full Text Available An application of the nonlinear saturation control (NSC algorithm for a self-excited strongly nonlinear beam structure driven by an external force is presented in the paper. The mathematical model accounts for an Euler-Bernoulli beam with nonlinear curvature, reduced to first mode oscillations. It is assumed that the beam vibrates in the presence of a harmonic excitation close to the first natural frequency of the beam, and additionally the beam is self-excited by fluid flow, which is modelled by a nonlinear Rayleigh term for self-excitation. The self- and externally excited vibrations have been reduced by the application of an active, saturation-based controller. The approximate analytical solutions for a full structure have been found by the multiple time scales method, up to the first-order approximation. The analytical solutions have been compared with numerical results obtained from direct integration of the ordinary differential equations of motion. Finally, the influence of a negative damping term and the controller's parameters for effective vibrations suppression are presented.

  8. Development of External Beam PIXE Set-up and Applications to Pottery Provenance Studies

    Nissinen, Tuomas

    2015-01-01

    Particle Induced X-ray Emission (PIXE) is an ion beam analysis technique. In PIXE, atoms in the sample are excited when the sample is bombarded with protons, alpha particles, or heavy ions. X-rays are emitted when atoms in the sample de-excite. Each element has unique characteristic x-rays. In the spectrum, area of each peak is proportional to the elemental concentration in the sample. The existing PIXE set-up in the accelerator laboratory was upgraded to external beam PIXE to do...

  9. Trace element analysis of placentas of alcoholics and controls with external beam PIXE

    External beam PIXE analysis with a proton beam of 2.4 MeV was used to study trace element concentrations in human placentas. The aim was to check the suitability of PIXE analysis regarding soft tissue samples. The elements of interest (Fe, Cu, Zn, Se, Br, Rb, and Sr) were easily detected. A comparison was made with placental samples of alcoholics and controls to determine whether trace element concentrations in the placenta play a role in the pathogenesis of fetal alcohol syndrome. (author)

  10. Dissipative instability of an intense e-beam in finite external magnetic field

    Full text: Microinstabilities, along with large-scale perturbations, play an important role in devices for controlled fusion. Last few decades substantial efforts have been made to understand microinstabilities in fusion plasma. They are accompanied by plasma heating and diffusion and can also greatly enhance plasma transport across magnetic-field lines. Plasma anomalous resistance is also being thought to be connected with microinstabilities. Most frequently encountered microinstabilities are that in current carrying plasma and in electron beams. The physical nature of intense e-beam instability in plasma significantly depends on many factors. Most important of them are: (i) beam current value (e.g. underlimiting) or overlimiting), (ii) level of overlap of the beam and the plasma fields, and (iii) dissipation. Dissipation plays an important role, particularly in dense fusion plasma. Dissipation of high level transforms instability to that of dissipative type. This takes place due to negative energy wave (NEW) of the beam space charge. Dissipation serves as a channel for energy withdrawal for excitation of this wave. Dissipative instabilities are coupled with resistive wall modes. On the other hand excitation NEW means coupling of dissipative and space charge phenomena. The influence of dissipation on various beam instabilities was considered. New type dissipative beam instability is substantiated. Its growth rate has more critical (as compared to conventional) dependence on dissipation. Consideration of the instability in infinite external magnetic field essentially simplifies the analysis. But in many cases such consideration is undesirable and even inappropriate. This investigation substantiates the new type of dissipative streaming instability for finite external magnetic field. The investigation also states that the evolution of the instability in space and time is governed by partial differential equation of second order independently on geometry and specific

  11. Calculation of the dose to lymphocytes in external beam radiation therapy

    Lymphopenia is known to occur in patients undergoing external beam radiation therapy when the radiation fields encompass major blood vessels and lymphatic tissue. The dose received by the lymphocytes has up to now not been determined. We present here a general formalism for the calculation of the lymphocyte dose for a patient undergoing fractionated radiation therapy at any irradiation site. The calculation procedure is demonstrated for a typical case of pelvic irradiation

  12. Calculation of the dose to lymphocytes in external beam radiation therapy

    Ekstrand, K.E.; Dixon, R.L.; Plunkett, S.; Raben, M.

    1981-02-01

    Lymphopenia is known to occur in patients undergoing external beam radiation therapy when the radiation fields encompass major blood vessels and lymphatic tissue. The dose received by the lymphocytes has up to now not been determined. We present here a general formalism for the calculation of the lymphocyte dose for a patient undergoing fractionated radiation therapy at any irradiation site. The calculation procedure is demonstrated for a typical case of pelvic irradiation.

  13. Longtime behavior for oscillations of an extensible viscoelastic beam with elastic external supply

    Bochicchio, Ivana

    2011-01-01

    This work is focused on a nonlinear equation describing the oscillations of an extensible viscoelastic beam with fixed ends, subject to distributed elastic external force. For a general axial load $\\beta$, the existence of a finite/infinite set of stationary solutions and buckling occurrence are scrutinized. The exponential stability of the straight position is discussed. Finally, the related dynamical system in the history space framework is shown to possess a regular global attractor.

  14. External Beam Accelerated Partial Breast Irradiation Yields Favorable Outcomes in Patients with Prior Breast Augmentation

    RachelYi-FengLei; CharlesELeonard; JaneMKercher; TereseKaske

    2014-01-01

    Purpose: To report outcomes in breast cancer patients with prior breast augmentation treated with external beam accelerated partial breast irradiation (EB-APBI) utilizing intensity modulated radiotherapy (IMRT) or 3-dimensional conformal radiotherapy (3D-CRT), both with image-guided radiotherapy (IGRT).Methods and Materials: 16 stage 0/I breast cancer patients with previous elective bilateral augmentation were treated post-lumpectomy on institutional EB-APBI trials (01185132 and 01185145 on c...

  15. T2-weighted endorectal magnetic resonance imaging of prostate cancer after external beam radiation therapy

    Antonio C. Westphalen

    2009-04-01

    Full Text Available PURPOSE: To retrospectively determine the accuracy of T2-weighted endorectal MR imaging in the detection of prostate cancer after external beam radiation therapy and to investigate the relationship between imaging accuracy and time since therapy. MATERIAL AND METHODS: Institutional review board approval was obtained and the study was HIPPA compliant. We identified 59 patients who underwent 1.5 Tesla endorectal MR imaging of the prostate between 1999 and 2006 after definitive external beam radiation therapy for biopsy-proven prostate cancer. Two readers recorded the presence or absence of tumor on T2-weighted images. Logistic regression and Fisher’s exact tests for 2x2 tables were used to determine the accuracy of imaging and investigate if accuracy differed between those imaged within 3 years of therapy (n = 25 and those imaged more than 3 years after therapy (n = 34. Transrectal biopsy was used as the standard of reference for the presence or absence of recurrent cancer. RESULTS: Thirty-four of 59 patients (58% had recurrent prostate cancer detected on biopsy. The overall accuracy of T2-weighted MR imaging in the detection cancer after external beam radiation therapy was 63% (37/59 for reader 1 and 71% for reader 2 (42/59. For both readers, logistic regression showed no difference in accuracy between those imaged within 3 years of therapy and those imaged more than 3 years after therapy (p = 0.86 for reader 1 and 0.44 for reader 2. CONCLUSION: T2-weighted endorectal MR imaging has low accuracy in the detection of prostate cancer after external beam radiation therapy, irrespective of the time since therapy.

  16. Salvage brachytherapy for locally recurrent prostate cancer after external beam radiotherapy

    Yasuhiro Yamada; Koji Okihara; Tsuyoshi Iwata; Koji Masui; Kazumi Kamoi; Kei Yamada; Tsuneharu Miki

    2015-01-01

    External beam radiotherapy (EBRT) is a standard treatment for prostate cancer. Despite the development of novel radiotherapy techniques such as intensity-modulated conformal radiotherapy, the risk of local recurrence after EBRT has not been obviated. Various local treatment options (including salvage prostatectomy, brachytherapy, cryotherapy, and high-intensity focused ultrasound [HIFU]) have been employed in cases of local recurrence after primary EBRT. Brachytherapy is the first-line treatm...

  17. Longitudinal motion in bunch compression and in the external beam line

    Heavy ion fusion simulation experiments on the SNS synchrotron in the fields of; momentum spread increase during debunching, storage ring bunch compression experiments at 70.44 MeV, and, briefly, longitudinal motion in external beam line, were evaluated qualitatively. Certain features that need attention were noted but overall it was concluded that the proposed experiments on the SNS would yield considerable insight into HIF drivers. (U.K.)

  18. In vivo dosimetry with thermoluminescent dosimeters in external photon beam radiotherapy

    Costa, Alessandro M. [Departamento de Fisica e Matematica, Faculdade de Filosofia, Ciencias e Letras de Ribeirao Preto, Universidade de Sao Paulo, Av. Bandeirantes 3900, 14040-901 Ribeirao Preto, SP (Brazil)], E-mail: amcosta@usp.br; Barbi, Gustavo L.; Bertucci, Edenyse C.; Ferreira, Heberton; Sansavino, Simone Z.; Colenci, Beatriz [Servico de Radioterapia, Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo, Av. Bandeirantes 3900, 14048-900 Ribeirao Preto, SP (Brazil); Caldas, Linda V.E. [Instituto de Pesquisas Energeticas e Nucleares, Comissao Nacional de Energia Nuclear, Av. Prof. Lineu Prestes 2242, 05508-000 Sao Paulo, SP (Brazil)

    2010-04-15

    The ultimate check of the actual dose delivered to a patient in radiotherapy can only be achieved by using in vivo dosimetry. This work reports a pilot study to test the applicability of a thermoluminescent dosimetric system for performing in vivo entrance dose measurements in external photon beam radiotherapy. The measurements demonstrated the value of thermoluminescent dosimetry as a treatment verification method and its applicability as a part of a quality assurance program in radiotherapy.

  19. In vivo dosimetry with thermoluminescent dosimeters in external photon beam radiotherapy

    The ultimate check of the actual dose delivered to a patient in radiotherapy can only be achieved by using in vivo dosimetry. This work reports a pilot study to test the applicability of a thermoluminescent dosimetric system for performing in vivo entrance dose measurements in external photon beam radiotherapy. The measurements demonstrated the value of thermoluminescent dosimetry as a treatment verification method and its applicability as a part of a quality assurance program in radiotherapy.

  20. External-beam radiotherapy as preparative regimen for hepatocyte transplantation after partial hepatectomy

    Purpose: The transplantation of donor hepatocytes is considered a promising option to correct chronic liver failure through repopulation of the diseased organ. This study describes a novel selective external-beam irradiation technique as a preparative regimen for hepatocyte transplantation. Methods and Materials: Livers of dipeptidylpeptidase IV (DPPIV)-deficient rats were preconditioned with external-beam single-dose irradiation (25 Gy) delivered to two thirds of the liver. Four days later, a one-third partial hepatectomy (PH) was performed to resect the untreated liver section, and 15 million wild-type (DPPIV+) hepatocytes were transplanted via the spleen into the recipient livers. The degree of donor-cell integration and growth was studied 8 h, 3 days, and 5 and 12 weeks after transplantation. Results: Transplanted hepatocytes integrated rapidly into the irradiated liver and proliferated as clusters, finally repopulating the host liver to approximately 20% hepatocyte mass. After 12 weeks, donor cells and their numerous descendents were fully integrated and expressed functional markers to the same extent as host hepatocytes. Conclusions: We demonstrate that external-beam liver irradiation is sufficient to achieve partial repopulation of the host liver after hepatocyte transplantation, under the additional stimulus of one-third PH. The method described has potentially good prospects for its application in a clinically viable form of treatment

  1. 3D FE Analysis of RC Beams Externally Strengthened with SRG/SRP Systems

    Francesco Bencardino

    2016-05-01

    Full Text Available The purpose of this study is to evaluate, through a nonlinear Finite Element (FE analysis, the structural behavior of Reinforced Concrete (RC beams externally strengthened by using Steel Reinforced Grout (SRG and Steel Reinforced Polymer (SRP systems. The parameters taken into account were the external strengthening configuration, with or without U-wrap end anchorages, as well as the strengthening materials. The numerical simulations were carried out by using a three-dimensional (3D FE model. The linear and nonlinear behavior of all materials was modeled by appropriate constitutive laws and the connection between concrete substrate and external reinforcing layer was simulated by means of cohesive surfaces with appropriate bond-slip laws. In order to overcome convergence difficulties, to simulate the quasi-static response of the strengthened RC beams, a dynamic approach was adopted. The numerical results in terms of load-displacement curves, failure modes, and load and strain values at critical stages were validated against some experimental data. As a result, the proposed 3D FE model can be used to predict the structural behavior up to ultimate stage of similar strengthened beams without carrying out experimental tests.

  2. Wavelength beam combining of a 980-nm tapered diode laser bar in an external cavity

    Vijayakumar, Deepak; Jensen, Ole Bjarlin; Thestrup, Birgitte

    2010-04-01

    High power diode lasers are used in a large number of applications. A limiting factor for more widespread use of broad area lasers is the poor beam quality. Gain guided tapered diode lasers are ideal candidates for industrial applications that demands watt level output power with good beam quality. By adapting a bar geometry, the output power could be scaled even up to several tens of watts. Unfortunately, the high divergence which is a characteristic feature of the bar geometry could lead to a degradation of the overall beam quality of the laser bar. However, spectral beam combining is an effective solution for preserving the beam quality of the bar in the range of that of a single emitter and at the same time, enabling the power scaling. We report spectral beam combining applied to a 12 emitter tapered laser bar at 980 nm. The external cavity has been designed for a wavelength separation of 4.0 nm between the emitters. An output power of 9 W has been achieved at an operating current of 30 A. The combined beam had an M2 value (1/e2) of 5.3 along the slow axis which is comparable to that of a single tapered emitter on the laser bar. The overall beam combining efficiency was measured to be 63%. The output spectrum of the individual emitters was narrowed considerably. In the free running mode, the individual emitters displayed a broad spectrum of the order of 0.5-1.0 nm while the spectral width has been reduced to 30-100 pm in the spectral beam combining mode.

  3. Unified model to predict flexural shear behavior of externally bonded RC beams

    Structural strengthening with externally bonded reinforcement is now recognized as a cost-effective, structurally sound and practically efficient method of rehabilitating deteriorating and damaged reinforced concrete beams. There is now an urgent need to develop a sound engineering basis which can predict the failure loads of all such strengthened beams in a reliable and consistent manner. Existing models to predict the behavior at ultimate of strengthened beams suffer from many limitations and weaknesses. This paper presents a unified global model, based on the Strut-and-Tie approach, to predict the failure loads of reinforced concrete beams strengthened for flexure and/or shear. This structural model is based on rational engineering principles, considers all the possible failure modes, and incorporates the load transfer mechanism bond to reflect the debonding phenomena which has a dominant influence on the failure process of plated beams. The model is validated against about 200 strengthened beam test reported in the literature and failing in flexure and/or shear, involving a large number of structural variables and steel, carbon and glass fiber reinforced polymer laminates as reinforcing medium. (author)

  4. Effectiveness of external unbonded reinforcement retrofitted to rc beams for flexural strengthening--experimental investigation

    The paper presents the effectiveness of the strengthening technique by way of retrofitting external unbounded non-prestressed conventional reinforcement. The focus of the study remains confined to effectiveness under varying parameters at ultimate only, through an experimental study. The changed structural behaviour and the effect of varying parameters have been discussed before presenting the results of an experimental study comprising of 30 simply supported reinforced concrete beam specimen tested under four point bending. The analysis of results demonstrated the effectiveness of the strengthening technique in terms of delay in yielding of bonded reinforcement, strengthening ratio and ductility of the strengthened beams under varying parameters. The technique thus has been shown to have promise as a strengthening technique for flexural strengthening of reinforced concrete beams. (author)

  5. Behavior of reinforced concrete beams strengthened with externally bonded hybrid fiber reinforced polymer systems

    Highlights: • RC beams strengthened with hybrid FRP sheets. • Carbon and Glass are the used FRP sheets. • Four point bending tests were conducted. • Both strength and ductility had been enhanced. - Abstract: This paper presents an experimental and an analytical investigation of the behavior of Reinforced Concrete (RC) beams strengthened in flexure by means of different combinations of externally bonded hybrid Glass and Carbon Fiber Reinforced Polymer (GFRP/CFRP) sheets. In order to obtain the mechanical properties of the hybrid sheets, multiple tensile coupon tests were conducted. In addition, an experimental program consisting of a control beam and four beams strengthened in flexure with GFRP, CFRP and hybrid FRP sheets was conducted. The series of the RC beams were tested under four point bending to study the flexural effectiveness of the proposed hybrid FRP sheets. The load–deflection response, strain readings at certain locations and associated failure modes of the tested specimens had been recorded. It is observed that the increase in the load capacity of the strengthened beams ranged from 30% to 98% of the un-strengthened control RC beam depending on the combination of the Carbon/Glass sheets. It was also observed that the ductility at failure loads of the beams strengthened with glass and hybrid sheets is higher than that with a single carbon sheet. Hence, the selection of the optimum combination of hybrid sheets can lead to a strengthening material which provides an improved ductility and strength in beam behavior. The load carrying capacity of the tested specimens was then predicted by the ACI 440.2R-08 guidelines. The predicted and measured results were in good agreement, within 5% for the control beam and for beams with one layer of strengthening sheet and between 13% and 17% for beams with two or more layers of hybrid strengthening sheets. Furthermore, an analytical model was developed to predict the load–deflection response of the tested

  6. Stability of aerosol droplets in Bessel beam optical traps under constant and pulsed external forces

    We report on the dynamics of aerosol droplets in optical traps under the influence of additional constant and pulsed external forces. Experimental results are compared with simulations of the three-dimensional droplet dynamics for two types of optical traps, the counter-propagating Bessel beam (CPBB) trap and the quadruple Bessel beam (QBB) trap. Under the influence of a constant gas flow (constant external force), the QBB trap is found to be more stable compared with the CPBB trap. By contrast, under pulsed laser excitation with laser pulse durations of nanoseconds (pulsed external force), the type of trap is of minor importance for the droplet stability. It typically needs pulsed laser forces that are several orders of magnitude higher than the optical forces to induce escape of the droplet from the trap. If the droplet strongly absorbs the pulsed laser light, these escape forces can be strongly reduced. The lower stability of absorbing droplets is a result of secondary thermal processes that cause droplet escape

  7. Evaluation of parotid function using dynamic parotid scintigraphy in nasopharyngeal carcinoma patients treated with external beam radiation therapy

    Objective: To evaluation of the parotid function using dynamic parotid scintigraphy in nasopharyngeal carcinoma patients treated with external beam radiation therapy. Methods: Twenty-one nasopharyngeal carcinoma patients were included into this study. Dynamic parotid scintigraphy was performed before and after external beam radiation therapy. Semi-quantitative parameters of parotid (uptake index, excretion rate and excretion index) was used to evaluate the changes of parotid function. Results: UI, ER and EI of parotid were decreased markedly after external beam radiation therapy, t is 56.65, 41.34, 30.69 respectively, P<0.001. The uptake and excretion function of the parotid were all impaired, which correlated with the dray mouth symptom of the patients. Conclusion: Dynamic parotid scintigraphy can play a key role in the evaluation of parotid function in nasopharyngeal carcinoma patients treated with external beam radiation therapy. (authors)

  8. Proton external beam in the TANDAR Accelerator; Haz externo de protones en el acelerador TANDAR

    Rey, R.; Schuff, J.A.; Perez de la Hoz, A.; Debray, M.E.; Hojman, D.; Kreiner, A.J.; Kesque, J.M.; Saint-Martin, G.; Oppezzo, O.; Bernaola, O.A.; Molinari, B.L.; Duran, H.A.; Policastro, L.; Palmieri, M.; Ibanez, J.; Stoliar, P.; Mazal, A.; Caraballo, M.E.; Burlon, A.; Cardona, M.A.; Vazquez, M.E.; Salfity, M.F.; Ozafran, M.J.; Naab, F.; Levinton, G.; Davidson, M.; Buhler, M. [Departamento de Fisica, Comision Nacional de Energia Atomica, Av. Gral. Paz 1499, C.P. 1650 San Martin, Buenos Aires (Argentina)

    1998-12-31

    An external proton beam has been obtained in the TANDAR accelerator with radiological and biomedical purposes. The protons have excellent physical properties for their use in radiotherapy allowing a very good accuracy in the dose spatial distribution inside the tissue so in the side direction as in depth owing to the presence of Bragg curve. The advantage of the accuracy in the dose localization with proton therapy is good documented (M. Wagner, Med. Phys. 9, 749 (1982); M. Goitein and F. Chen, Med. Phys. 10, 831 (1983); M.R. Raju, Rad. Res. 145, 391 (1996)). It was obtained external proton beams with energies between 15-25 MeV, currents between 2-10 p A and a uniform transversal sections of 40 mm{sup 2} approximately. It was realized dosimetric evaluations with CR39 and Makrofol foliation. The irradiations over biological material contained experiences In vivo with laboratory animals, cellular and bacterial crops. It was fixed the optimal conditions of position and immobilization of the Wistar rats breeding for the In vivo studies. It was chosen dilutions and sowing techniques adequate for the exposition at the cellular and bacterial crops beam. (Author)

  9. Nonlinear dynamics of axially moving viscoelastic Timoshenko beam under parametric and external excitations

    Qiaoyun YAN; Hu DING; Liqun CHEN

    2015-01-01

    This investigation focuses on the nonlinear dynamic behaviors in the trans-verse vibration of an axially accelerating viscoelastic Timoshenko beam with the external harmonic excitation. The parametric excitation is caused by the harmonic fluctuations of the axial moving speed. An integro-partial-differential equation governing the transverse vibration of the Timoshenko beam is established. Many factors are considered, such as viscoelasticity, the finite axial support rigidity, and the longitudinally varying tension due to the axial acceleration. With the Galerkin truncation method, a set of nonlinear ordinary differential equations are derived by discretizing the governing equation. Based on the numerical solutions, the bifurcation diagrams are presented to study the effect of the external transverse excitation. Moreover, the frequencies of the two excitations are assumed to be multiple. Further, five different tools, including the time history, the Poincar´e map, and the sensitivity to initial conditions, are used to identify the motion form of the nonlinear vibration. Numerical results also show the characteristics of the quasiperiodic motion of the translating Timoshenko beam under an incommensurable re-lationship between the dual-frequency excitations.

  10. Kilovoltage Rotational External Beam Radiotherapy on a Breast Computed Tomography Platform: A Feasibility Study

    Prionas, Nicolas D.; McKenney, Sarah E. [Department of Radiology, University of California, Davis, Medical Center, Sacramento, California (United States); Stern, Robin L. [Department of Radiation Oncology, University of California, Davis, Medical Center, Sacramento, California (United States); Boone, John M., E-mail: jmboone@ucdavis.edu [Department of Radiology, University of California, Davis, Medical Center, Sacramento, California (United States)

    2012-10-01

    Purpose: To demonstrate the feasibility of a dedicated breast computed tomography (bCT) platform to deliver rotational kilovoltage (kV) external beam radiotherapy (RT) for partial breast irradiation, whole breast irradiation, and dose painting. Methods and Materials: Rotational kV-external beam RT using the geometry of a prototype bCT platform was evaluated using a Monte Carlo simulator. A point source emitting 178 keV photons (approximating a 320-kVp spectrum with 4-mm copper filtration) was rotated around a 14-cm voxelized polyethylene disk (0.1 cm tall) or cylinder (9 cm tall) to simulate primary and primary plus scattered photon interactions, respectively. Simulations were also performed using voxelized bCT patient images. Beam collimation was varied in the x-y plane (1-14 cm) and in the z-direction (0.1-10 cm). Dose painting for multiple foci, line, and ring distributions was demonstrated using multiple rotations with varying beam collimation. Simulations using the scanner's native hardware (120 kVp filtered by 0.2-mm copper) were validated experimentally. Results: As the x-y collimator was narrowed, the two-dimensional dose profiles shifted from a cupped profile with a high edge dose to an increasingly peaked central dose distribution with a sharp dose falloff. Using a 1-cm beam, the cylinder edge dose was <7% of the dose deposition at the cylinder center. Simulations using 120-kVp X-rays showed distributions similar to the experimental measurements. A homogeneous dose distribution (<2.5% dose fluctuation) with a 20% decrease in dose deposition at the cylinder edge (i.e., skin sparing) was demonstrated by weighted summation of four dose profiles using different collimation widths. Simulations using patient bCT images demonstrated the potential for treatment planning and image-guided RT. Conclusions: Rotational kV-external beam RT for partial breast irradiation, dose painting, and whole breast irradiation with skin sparing is feasible on a bCT platform

  11. External beam radiation therapy followed by high-dose-rate brachytherapy for inoperable superficial esophageal carcinoma

    Purpose: The aim of this study was to retrospectively evaluate the feasibility, efficacy, and tolerance of external beam radiotherapy followed by high-dose-rate brachytherapy in inoperable patients with superficial esophageal cancer. Patients and Methods: From November 1992 to May 1999, 66 patients with superficial esophageal cancer were treated with exclusive radiotherapy. The median age was 60 years (range, 41-85). Fifty-three percent of them were ineligible for surgery owing to synchronous or previously treated head-and-neck cancer. Most of the patients (n = 49) were evaluated with endoscopic ultrasonography (EUS) or computed tomography (CT). The mean doses of external beam radiotherapy and high-dose rate brachytherapy were 57.1 Gy (±4.83) and 8.82 Gy (±3.98), respectively. The most frequently used regimen was 60 Gy followed by 7 Gy at 5 mm depth in two applications. Results: Among patients evaluated with EUS or CT, the complete response rate was 98%. The 3-, 5-, and 7-year survival rates were 57.9%, 35.6%, and 26.6%, respectively. Median overall survival was 3.8 years. The 5-year relapse-free survival and cause-specific survival were 54.6% and 76.9%. The 5-year overall, relapse-free, and cause-specific survival of the whole population of 66 patients was 33%, 53%, and 77%, respectively. Local failure occurred in 15 of 66 patients; 6 were treated with brachytherapy. Severe late toxicity (mostly esophageal stenosis) rated according to the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer scale occurred in 6 of 66 patients (9%). Conclusion: This well tolerated regimen may be a therapeutic alternative for inoperable patients with superficial esophageal cancer. Only a randomized study could be able to check the potential benefit of brachytherapy after external beam radiation in superficial esophageal cancer

  12. Analyses of inks and papers in historical documents through external beam PIXE techniques

    PIXE analyses of documents can be carried out to high senstitivty in an external beam configuration designed to protect historical materials from damage. Test runs have shown that a properbly designed system with high solid angle can operate at less than 1% of the flux necessary to cause any discoloration whatsoever on papers of the 17th and 18th centuries. The composition of these papers is suprisingly complex, yet retains distinct association with the historical period, paper source, and even the individual sheets of paper that are folded and cut to make groups of pages. Early studies are planned on historical forgeries. (orig.)

  13. Non-destructive analysis of early glass unearthed in south China by external-beam PIXE

    External-beam PIXE was used for the non-destructive analysis of early glasses unearthed from the tombs of Warring States (475-221 BC) and Han Dynasty (BC 206-AD 220) in south China. It was found that these glasses were basically attributed to PbO-BaO-SiO2 system and K2O-SiO2 system. The results from the cluster analysis showed that some glasses had exactly the same recipe. The source of the K2O flux and the correlation between PbO and BaO are discussed. Some archaeological information is revealed. (author)

  14. Elemental analysis of ancient Chinese bronze artifacts with external-beam PIXE

    External-beam PIXE has been applied for the determination of the elemental composition of ancient Chinese bronze artifacts. Characteristic x-ray spectra from the samples bombarded with protons of 3 MeV have been measured with a HPGe detector. At each sample three spots were irradiated per run. Results of measurements on three fragments of bronze drinking vessels and helmet of Chinese ancient Chou and Shang dynasties (17th-8th century B.C.) are presented. To check the analytical method, we have also made measurements on the elemental composition of some modern coins. The results are discussed. (author)

  15. Electron beam guiding by external magnetic fields in imploded fuel plasma

    Johzaki, T.; Sentoku, Y.; Nagatomo, H.; Sunahara, A.; Sakagami, H.; Fujioka, S.; Shiraga, H.; Endo, T.; FIREX project group

    2016-05-01

    For enhancing the core heating efficiency in fast ignition laser fusion, we proposed the fast electron beam by externally-applied the kilo-tesla (kT) class longitudinal magnetic field. We evaluated the imploded core and the magnetic field profiles formed through the implosion dynamics by resistive MHD radiation hydro code. Using those profiles, the guiding effect was evaluated by fast electron transport simulations, which shows that in addition to the feasible field configuration (moderate mirror ratio), the kT-class magnetic field is required at the fast electron generation point. In this case, the significant enhancement in heating efficiency is expected.

  16. Phase-space database for external beam radiotherapy. Summary report of a consultants' meeting

    A summary is given of a Consultants' Meeting assembled to discuss and recommend actions and activities to prepare a Phase-space Database for External Beam Radiotherapy. The new database should serve to disseminate phase-space data of those accelerators and 60Co units used in radiotherapy through the compilation of existing data that have been properly validated. Both the technical discussions and the resulting work plan are described, along with the detailed recommendations for implementation. The meeting was jointly organized by NAPC-Nuclear Data Section and NAHU-Dosimetry and Medical Radiation Physics Section. (author)

  17. An Apparatus For Student Projects Using External-Beam PIXE And PIGE

    Correll, Francis D.; Edsall, Douglas W.; DePooter, Katherine A.; Maskell, Nicholas D.; Vanhoy, Jeffrey R.

    2011-06-01

    We recently installed a simple endstation at the Naval Academy Tandem Accelerator Laboratory to support student projects using external-beam PIXE and PIGE. It consists of a short, graphite-lined beamline extension with a thin window, an interlocked box that surrounds the target, detectors for x- and gamma rays, provision for flooding the target with helium gas, easily changed x-ray absorbers, and a compact video camera for monitoring the position of the beam spot. We used this system to measure the elemental composition of colonial-era architectural materials, principally bricks and mortar, from James Madison's Montpelier, the reconstructed Virginia estate of the fourth President of the United States. We describe the design and construction of the system, relate some of our experiences using it, and present some preliminary data from our investigations.

  18. An Apparatus For Student Projects Using External-Beam PIXE And PIGE

    We recently installed a simple endstation at the Naval Academy Tandem Accelerator Laboratory to support student projects using external-beam PIXE and PIGE. It consists of a short, graphite-lined beamline extension with a thin window, an interlocked box that surrounds the target, detectors for x- and gamma rays, provision for flooding the target with helium gas, easily changed x-ray absorbers, and a compact video camera for monitoring the position of the beam spot. We used this system to measure the elemental composition of colonial-era architectural materials, principally bricks and mortar, from James Madison's Montpelier, the reconstructed Virginia estate of the fourth President of the United States. We describe the design and construction of the system, relate some of our experiences using it, and present some preliminary data from our investigations.

  19. External audit of photon beams by mailed film dosimetry: feasibility study

    A feasibility study for mailed film dosimetry has been performed. The global reproducibility of the method is better than 2%. It is shown that the normalized sensitometric curve does not depend on photon beam quality in the range from Co-60 γ-rays to 18 MV x-rays, although the dose per optical density decreases when the energy increases. The fading of the latent image before film processing is only 3% per month and the normalized sensitometric curve is not modified after a period of 51 days between irradiation and processing. Sets of films were mailed to three different institutes for irradiation and returned for processing and evaluation after more than two months in order to verify that mailing of irradiated and unprocessed films does not produce unwanted artefacts. Finally the feasibility of external audits with mailed film dosimetry is illustrated by comparison of beam profiles measured with films and ionization chambers in a polystyrene phantom. (author)

  20. The Device to Measure Currents in External Beam Transportation Lines of the DC-72 Cyclotron

    Gulbekyan, G G; Gall, A; Kalagin, I V; Timoshenko, G N; Pachadzhiev, K K

    2002-01-01

    The present work is devoted to the development of a device to measure ion currents in external beam transportation lines of the DC-72 cyclotron, which is being created for the Cyclotron Centre of the Slovak Republic. The device is based on a Faraday cup. As possible constructive materials for the Faraday cup, Al, Cu, Fe, W and C were considered from the point of view of both the residual radiation and heating by the proton beam of the 3 kW power. Based on the calculations performed. It was suggested to use aluminium. The results of calculations of the temperature distribution in cylindrical and conic cups have been presented, both for a proton energy of 30 MeV at a beam power of 3 kW, and for a proton energy of 72 MeV at a beam power of 2.5 kW. Also presented are the results of calculation of the construction with permanent magnets that create sufficient magnetic field to eliminate the influence of secondary electrons emission on the current measurement accuracy. As a result, a sketch of the device constructi...

  1. Characterization of a computed radiography system for external radiotherapy beam dosimetry

    Aberle, Christoph; Kapsch, Ralf-Peter

    2016-06-01

    A commercial computed radiography (CR) system was studied as an option for quantitative dosimetry quality assurance of external radiotherapy beams. Following the examination of influencing quantities, practical measurement procedures are discussed. Corrections were derived for image fading, an observed long-term response drift and the image length scale, which was found to be off by up to 2–3%. It is known that energy dependence is important for CR measurements. Therefore, signal-to-dose calibration curves and the energy dependence of the response were studied extensively using multiple photon and electron beam qualities. Doses which yield the same signal vary by up to tens of percent for different beam qualities. Results on the directional response of the plates are presented. It was found that rotations of up to 30° to 40° relative to perpendicular irradiation yield no significant change in response. Finally, the homogeneity of the response over the measurement region was studied for electrons and photons and a correction method is described. In summary, relative dose measurements with uncertainties of a few percent are feasible in regions of constant beam energy.

  2. Multioobjective inverse planning for external beam radiotherapy: decoupling the optimization and decision processes

    Inverse planning in radiation therapy is a trial and error process and many studies have been published which consider different algorithms, constraints, cases and objective functions. These planning algorithms combine in a specific way the objectives that are in conflict but do not provide the information that is necessary to obtain an optimal solution. Only in the last few years have significant increases in the availability of computing power enabled inverse planning to be performed to provide the information necessary to understand the possibilities of all dose distributions that can be obtained. We consider in this paper this multiobjective approach for external beam radiation therapy inverse planning that decouples the optimization and decision making processes. Inverse planning can now consider the number of beams, their orientation and optimal beam fluences and their dependence on importance factors. In this way it is possible to exploit the possibilities of advanced technologies such as intensity modulated radiation therapy (IMRT) or tomotherapy. Using data mining and visualization techniques a solution can be selected that requires, if possible, a small number of beams, and that also provides the required dose delivery to the target. Additionally, it allows reduction of the dose in the healthy tissue, especially in organs at risk, in such a way that the compromise we have to make for all the objectives in comparison to the best individual values is as small as possible. (author)

  3. Interfacial stresses in damaged RC beams strengthened with externally bonded CFRP plate

    Benrahou, K.H. [Laboratoire des Materiaux et Hydrologie, Universite de Sidi Bel Abbes, BP 89 Cite Ben M' hidi 22000 Sidi Bel Abbes (Algeria); Adda bedia, E.A. [Laboratoire des Materiaux et Hydrologie, Universite de Sidi Bel Abbes, BP 89 Cite Ben M' hidi 22000 Sidi Bel Abbes (Algeria)]. E-mail: addabed@yahoo.com; Benyoucef, S. [Laboratoire des Materiaux et Hydrologie, Universite de Sidi Bel Abbes, BP 89 Cite Ben M' hidi 22000 Sidi Bel Abbes (Algeria); Tounsi, A. [Laboratoire des Materiaux et Hydrologie, Universite de Sidi Bel Abbes, BP 89 Cite Ben M' hidi 22000 Sidi Bel Abbes (Algeria); Benguediab, M. [Laboratoire des Materiaux et Hydrologie, Universite de Sidi Bel Abbes, BP 89 Cite Ben M' hidi 22000 Sidi Bel Abbes (Algeria)

    2006-09-25

    A theoretical method to predict the interfacial stresses in the adhesive layer of damaged reinforced concrete beams strengthened with externally bonded carbon fiber-reinforced polymer (CFRP) plate is presented. The adopted model is developed including the adherend shear deformations by assuming a linear shear stress through the depth of the RC beam [A. Tounsi, Int. J. Solids Struct., in press], while all existing solutions neglect this effect [e.g. S. Benyoucef, A. Tounsi, S.A. Meftah, E.A. Adda Bedia, Compos. Interfaces, in press; S.T. Smith, J.G. Teng, Eng. Struct. 23 (7) (2001) 857-871; T.M. Roberts, Struct. Eng. 67 (12) (1989) 229-233; A. Tounsi, S. Benyoucef, Int. J. Adhes. Adhes., in press; T. Stratford, J. Cadei, Construct. Building Mater. 20 (2006) 34-35]. In addition, in the present study the anisotropic damage model is adopted to describe the damage of the RC beams. It is shown that the damage has a significant effect on the interfacial stresses in FRP-damaged RC beam.

  4. The external proton beam lines and the splitter systems of the CERN SPS

    Evans, Lyndon R; Ijspeert, Albert; de Raad, Bastiaan; Siegel, N; Weisse, E

    1977-01-01

    The exploitation of the CERN Super Proton Synchrotron (SPS) is based on two experimental areas, the West Area and the North Area. The West Area consists of the West Experimental Hall, fed by a slow ejected proton beam of 200 GeV/c maximum momentum and a Neutrino Facility which is fed by protons of 400 GeV/c. Several important detectors are installed in the West Area, the Omega spectrometer, the Big European Bubble Chamber and the heavy liquid bubble chamber Gargamelle. The North Area has been built for physics at 400 GeV/c. At present it consists of two experimental halls, a large multipurpose hall and a smaller hall dedicated to muon physics. The protons are extracted from the SPS in two of the six long straight sections (LSS) and are transported from the underground machine through a system of tunnels to the external targets. Both the beam lines to the West and North Area contain beam splitting stations which divide the slow extracted proton beam into three branches. (0 refs).

  5. Interfacial stresses in damaged RC beams strengthened with externally bonded CFRP plate

    A theoretical method to predict the interfacial stresses in the adhesive layer of damaged reinforced concrete beams strengthened with externally bonded carbon fiber-reinforced polymer (CFRP) plate is presented. The adopted model is developed including the adherend shear deformations by assuming a linear shear stress through the depth of the RC beam [A. Tounsi, Int. J. Solids Struct., in press], while all existing solutions neglect this effect [e.g. S. Benyoucef, A. Tounsi, S.A. Meftah, E.A. Adda Bedia, Compos. Interfaces, in press; S.T. Smith, J.G. Teng, Eng. Struct. 23 (7) (2001) 857-871; T.M. Roberts, Struct. Eng. 67 (12) (1989) 229-233; A. Tounsi, S. Benyoucef, Int. J. Adhes. Adhes., in press; T. Stratford, J. Cadei, Construct. Building Mater. 20 (2006) 34-35]. In addition, in the present study the anisotropic damage model is adopted to describe the damage of the RC beams. It is shown that the damage has a significant effect on the interfacial stresses in FRP-damaged RC beam

  6. Time-dependent behavior of RC beams strengthened with externally bonded FRP plates: interfacial stresses analysis

    Benyoucef, S.; Tounsi, A.; Benrahou, K. H.; Adda Bedia, E. A.

    2007-12-01

    External bonding of fibre reinforced polymer (FRP) composites has becomes a popular technique for strengthening concrete structures all over the world. An important failure mode of such strengthened members is the debonding of the FRP plate from the concrete due to high interfacial stresses near the plate ends. For correctly installed FRP plate, failure will occur within the concrete. Accurate predictions of the interfacial stresses are prerequisite for designing against debonding failures. In particular, the interfacial stresses between a beam and soffit plate within the linear elastic range have been addressed by numerous analytical investigations. In this study, the time-dependent behavior of RC beams bonded with thin composite plate was investigated theoretically by including the effect of the adherend shear deformations. The time effects considered here are those that arise from shrinkage and creep deformations of the concrete. This paper presents an analytical model for the interfacial stresses between RC beam and a thin FRP plate bonded to its soffit. The influence of creep and shrinkage effect relative to the time of the casting and the time of the loading of the beams is taken into account. Numerical results from the present analysis are presented to illustrate the significance of time-dependent of adhesive stresses.

  7. Clinically diagnosed glomus vagale tumour treated with external beam radiotherapy: a review of the published reports

    Full text: The aim of the study was to present a case of clinically diagnosed glomus vagale in a 42-year-old Aboriginal woman treated with external beam radiotherapy and to carry out a review of the published work. The details of presentation, diagnosis, treatment and follow up of the patient are discussed. A review of the published work was carry out using MEDLINE database with respect to aetiology, clinical presentation, diagnosis, treatment and expected outcomes. Glomus vagale tumours are a subtype of paragangliomas of the head and neck derived from extra-adrenal paraganglia of the autonomic nervous system. They are typically slow-growing, benign masses that are often asymptomatic and rarely show signs of hypersecretion. Treatment options include embolization, surgical excision, radiotherapy or surveillance. Radiotherapy is often used for extensive lesions where surgery is considered prohibitively morbid. Following treatment relapse rates are low with the most patients achieving long-term control. Our patient presented with an extensive lesion compressing the wall of the carotid artery and invading the jugular fossa to involve the clivus. Surgery was offered; however, the patient opted for external beam radiotherapy. A dose of 45 Gy in 25 fractions was delivered with 6-MV photons employing a CT-planned, wedge pair technique. Glomus vagale tumours are rare and should be managed in a multidisciplinary head and neck clinic with both surgical and radiation oncology opinions offered. The toxicities and outcomes of both methods should be discussed

  8. External beam radiation therapy for the treatment of subretinal neovascularization: experience with 140 patients

    Purpose/Objectives: Several clinical series with relatively small numbers of patients and short durations of follow-up have demonstrated that external beam radiation may be effective in treating subretinal neovascularization, a major cause of blindness in the U.S. This prospective study evaluates the efficacy of this treatment in a larger cohort of patients with a longer duration of follow-up than any previously reported series. Materials and Methods: One hundred forty patients between the ages of 50 and 96 were enrolled in this study between March 1994 and March 1996. Forty patients had previously undergone laser photocoagulation for subretinal neovascularization at other sites. Pretreatment visual acuity in the irradiated eyes was at least (20(400)). Prior to the initiation of external beam radiation therapy all patients underwent fluorocein angiography and indirect ophthalmoscopy to document the extent of neovascularization. Treatments were administered via single lateral photon beams of 4 - 6 MV energy, angled 5 degree sign - 10 degree sign posteriorly to avoid the anterior segment of the contralateral eye. Seventy-five patients received 1400 - 1500 cGy in 7-8 fractions while the remaining 65 patients received 1800 cGy in 9-10 fractions. Results: Transient epiphora and conjunctival irritation appeared to be more common in patients receiving 1800 cGy as opposed to 1400 - 1500 cGy. All patients underwent repeat ophthalmoscopy and angiography at three month intervals following treatment. Within three months of treatment, we noted regression or stabilization of retinal hemorrhages and exudates in over 85% of patients. Approximately 75% of patients followed for at least six months have maintained within two lines of their pre-treatment visual acuity. There was no significant difference in response to treatment between the 1400 - 1500 cGy and 1800 cGy arms. Conclusion: This study includes more patients with longer follow-up than any previously reported series. It

  9. External-beam PIXE analysis of aerosol samples at GIC4117 Tandem Accelerator Laboratory of Beijing Normal University

    Full text: The external-beam facility at GIC4117 tandem accelerator laboratory of Beijing Normal University for PIXE analysis has been introduced, the influence of different aerosol sampling membrane filters on the beam current measurement with a homemade Faraday cup was studied by analysis of a Mn(44.0μg/cm2) MicroMatter standards sample with different filters behind it. Average and the lowest of the external-beam PIXE analysis compared with in-vacuum PIXE over about 360 aerosol samples. External-beam PIXE analysis results of PM2.5 aerosol fractions collected on Teflon filters on daily basis over 2010 at south campus of Beijing Normal University also were shown. (author)

  10. Malignant obstructive jaundice: treatment with external-beam and intracavitary radiotherapy

    Eleven patients with obstructive jaundice from unresectable cholangiocarcinoma, metastatic porta hepatis adenopathy, or direct compression from a pancreatic malignancy were treated at the Stanford University Medical Center from 1978-1983 with an external drainage procedure followed by high-dose external-beam radiotherapy and by an intracavitary boost to the site of obstruction with Iridium192 (Ir192). A median dose of 5000 cGy was delivered with 4-6 Mv photons to the tumor bed and regional lymphatics in 9 patients, 1 patient received 2100 cGy to the liver in accelerated fractions because of extensive intrahepatic disease, and 1 patient received 7000 equivalent cGy to his pancreatic tumor bed and regional lymphatics with neon heavy particles. An Ir192 wire source later delivered a 3100-10,647 cGy boost to the site of biliary obstruction in each patient, for a mean combined dose of 10,202 cGy to a point 5 mm from the line source. Few acute complications were noted, but 3/11 patients (27%) subsequently developed upper gastrointestinal bleeding from duodenitis or frank duodenal ulceration 4 weeks, 4 months, and 7.5 months following treatment. Eight patients died - 5 with local recurrence +/- distant metastasis, 2 with sepsis, and 1 with widespread systemic metastasis. Autopsies revealed no evidence of biliary tree obstruction in 3/3 patients. Evolution of radiation treatment technqiues for biliary obstruction in the literature is reviewed. High-dose external-beam therapy followed by high-dose Ir192 intracavitary boost is well tolerated and provides significant palliation

  11. Malignant obstructive jaundice: treatment with external-beam and intracavitary radiotherapy

    Johnson, D.W.; Safai, C.; Goffinet, D.R.

    1985-02-01

    Eleven patients with obstructive jaundice from unresectable cholangiocarcinoma, metastatic porta hepatis adenopathy, or direct compression from a pancreatic malignancy were treated at the Stanford University Medical Center from 1978-1983 with an external drainage procedure followed by high-dose external-beam radiotherapy and by an intracavitary boost to the site of obstruction with Iridium/sup 192/ (Ir/sup 192/). A median dose of 5000 cGy was delivered with 4-6 Mv photons to the tumor bed and regional lymphatics in 9 patients, 1 patient received 2100 cGy to the liver in accelerated fractions because of extensive intrahepatic disease, and 1 patient received 7000 equivalent cGy to his pancreatic tumor bed and regional lymphatics with neon heavy particles. An Ir/sup 192/ wire source later delivered a 3100-10,647 cGy boost to the site of biliary obstruction in each patient, for a mean combined dose of 10,202 cGy to a point 5 mm from the line source. Few acute complications were noted, but 3/11 patients (27%) subsequently developed upper gastrointestinal bleeding from duodenitis or frank duodenal ulceration 4 weeks, 4 months, and 7.5 months following treatment. Eight patients died - 5 with local recurrence +/- distant metastasis, 2 with sepsis, and 1 with widespread systemic metastasis. Autopsies revealed no evidence of biliary tree obstruction in 3/3 patients. Evolution of radiation treatment technqiues for biliary obstruction in the literature is reviewed. High-dose external-beam therapy followed by high-dose Ir/sup 192/ intracavitary boost is well tolerated and provides significant palliation.

  12. Phase II Radiation therapy oncology group trial of weekly paclitaxel and conventional external beam radiation therapy for supratentorial glioblastoma multiforme

    Purpose: Fractionated external beam radiotherapy (EBRT) ± carmustine (BCNU) is the standard of care for patients with glioblastoma multiforme (GBM), but survival results remain poor. Preclinical studies indicate synergy between RT and paclitaxel (TAX) in astrocytoma cell lines. Phase I studies in GBM have demonstrated a maximum tolerated dose for TAX of 225 mg/m2/3 h/week x 6, during EBRT, with no exacerbation of typical RT-induced toxicities. The Radiation Therapy Oncology Group (RTOG) therefore mounted a Phase II study to determine the feasibility and efficacy of conventional EBRT and concurrent weekly TAX at its MTD. Patients and Methods: Sixty-two patients with histologic diagnosis of GBM were enrolled from 8/16/96 through 3/21/97 in a multi-institutional Phase II trial of EBRT and TAX 225 mg/m2/3 h (1-3 h before EBRT), administered the first treatment day of each RT week. Total EBRT dose was 60 Gy (200 cGy/fraction), 5 days per week. A smaller treatment field, to include gross disease plus a margin only, was used after 46 Gy. Results: Sixty-one patients (98%) were evaluable. Median age was 55 years (range, 28-78). Seventy-four percent were ≥50 years. Recursive partitioning analysis (RPA) Classes III, IV, V, VI included 10 (17%), 21 (34%), 25 (41%), and 5 (8%) patients, respectively. Gross total resection was performed in only 16%. There was no Grade 3 or 4 neutropenia or thrombocytopenia. Hypersensitivity reactions precluding further use of TAX occurred in 4 patients. There were 2 instances of late neurotoxicity (4% Grade 3 or 4). Ninety-one percent of patients received treatment per protocol. Seventy-seven percent completed prescribed treatment (6 weeks). Of 35 patients with measurable disease, CR/PR was observed in 23%, MR in 17%, and SD in 43%. Seventeen percent demonstrated progression at first follow-up. Median potential follow-up time is 20 months. Median survival is 9.7 months, with median survivals for RPA classes III, IV, V, and VI of 16.3, 10.2, 9

  13. Biochemical Response to Androgen Deprivation Therapy Before External Beam Radiation Therapy Predicts Long-term Prostate Cancer Survival Outcomes

    Zelefsky, Michael J., E-mail: zelefskm@mskcc.org [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Gomez, Daniel R.; Polkinghorn, William R.; Pei, Xin; Kollmeier, Marisa [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)

    2013-07-01

    Purpose: To determine whether the response to neoadjuvant androgen deprivation therapy (ADT) defined by a decline in prostate-specific antigen (PSA) to nadir values is associated with improved survival outcomes after external beam radiation therapy (EBRT) for prostate cancer. Methods and Materials: One thousand forty-five patients with localized prostate cancer were treated with definitive EBRT in conjunction with neoadjuvant and concurrent ADT. A 6-month course of ADT was used (3 months during the neoadjuvant phase and 2 to 3 months concurrently with EBRT). The median EBRT prescription dose was 81 Gy using a conformal-based technique. The median follow-up time was 8.5 years. Results: The 10-year PSA relapse-free survival outcome among patients with pre-radiation therapy PSA nadirs of ≤0.3 ng/mL was 74.3%, compared with 57.7% for patients with higher PSA nadir values (P<.001). The 10-year distant metastases-free survival outcome among patients with pre-radiation therapy PSA nadirs of ≤0.3 ng/mL was 86.1%, compared with 78.6% for patients with higher PSA nadir values (P=.004). In a competing-risk analysis, prostate cancer-related deaths were also significantly reduced among patients with pre-radiation therapy PSA nadirs of <0.3 ng/mL compared with higher values (7.8% compared with 13.7%; P=.009). Multivariable analysis demonstrated that the pre-EBRT PSA nadir value was a significant predictor of long-term biochemical tumor control, distant metastases-free survival, and cause-specific survival outcomes. Conclusions: Pre-radiation therapy nadir PSA values of ≤0.3 ng/mL after neoadjuvant ADT were associated with improved long-term biochemical tumor control, reduction in distant metastases, and prostate cancer-related death. Patients with higher nadir values may require alternative adjuvant therapies to improve outcomes.

  14. Use of an Anthropomorphic Phantom to Improve the External Beam Quality Audits in Radiotherapy

    The present paper describes the Cuban experience in the implementation of an external quality audit system for high energy radiotherapy photon beams (60Co and linac) in non-reference conditions using a thorax (CIRS) phantom. By comparing the calculated and actually delivered doses for four test cases, it is possible to check the quality of the entire planning chain from prescription to delivery as well as the integrity of the beam data modelled into the treatment planning system (TPS). The test cases were taken/modified from IAEA TRS 430 and include direct, tangential, wedged, blocked and multiple fields, all commonly used in clinic. According to the available insertion holes in the phantom, a number of dose points were defined and calculated with four different clinical TPSs used in our environment. Subsequently the dose was measured at these points with an ionization chamber. A set of audit results with on-site measurement are shown to demonstrate the practicability of the method. The points were classified by regions according to their position with respect to the beam axis. The 90% of measured points were found within tolerance. For the failing 10% we found no correlation with TPS (centre) or with the complexity of the case. For all test cases, except the simplest one, at least one department/TPS prediction falls outside tolerance. There is no significant difference among the audited departments. (author)

  15. Development of a multi-detector and a systematic imaging system on the AGLAE external beam

    Pichon, L., E-mail: laurent.pichon@culture.gouv.fr [Centre de recherche et de restauration des musées de France, C2RMF, Palais du Louvre – Porte des Lions, 14 Quai François Mitterrand, 75001 Paris (France); Fédération de recherche NewAGLAE, FR3506 CNRS/Ministère de la Culture/UPMC, Palais du Louvre, 75001 Paris (France); Moignard, B.; Lemasson, Q.; Pacheco, C. [Centre de recherche et de restauration des musées de France, C2RMF, Palais du Louvre – Porte des Lions, 14 Quai François Mitterrand, 75001 Paris (France); Fédération de recherche NewAGLAE, FR3506 CNRS/Ministère de la Culture/UPMC, Palais du Louvre, 75001 Paris (France); Walter, P. [Fédération de recherche NewAGLAE, FR3506 CNRS/Ministère de la Culture/UPMC, Palais du Louvre, 75001 Paris (France); UPMC Univ Paris 06, CNRS-UMR 8220, Laboratoire d’archéologie moléculaire et structurale, LAMS, F-75005 Paris (France)

    2014-01-01

    The New AGLAE external beamline provides analytical data for the understanding of the structure of archaeological and artistic objects, their composition, properties, and changes over time. One of the objectives of this project is to design and set up a new non-invasive acquisition system increasing the quality of the X-ray spectra and reducing the beam current on sensitive materials from work of art. To that end, the surface and the number of PIXE detectors have been increased to implement a cluster of SDD detectors. This can also provide the possibility to accomplish large and/or fast maps on artifacts with a scanning of the beam on the sample. During the mapping, a multi-parameter system saves each event from X-ray, gamma and particle detectors, simultaneously with the X and Y positions of the beam on the sample. To process the data, different softwares have been developed or updated. A first example on a decorated medieval shard highlights the perspectives of the technique.

  16. Development of a multi-detector and a systematic imaging system on the AGLAE external beam

    The New AGLAE external beamline provides analytical data for the understanding of the structure of archaeological and artistic objects, their composition, properties, and changes over time. One of the objectives of this project is to design and set up a new non-invasive acquisition system increasing the quality of the X-ray spectra and reducing the beam current on sensitive materials from work of art. To that end, the surface and the number of PIXE detectors have been increased to implement a cluster of SDD detectors. This can also provide the possibility to accomplish large and/or fast maps on artifacts with a scanning of the beam on the sample. During the mapping, a multi-parameter system saves each event from X-ray, gamma and particle detectors, simultaneously with the X and Y positions of the beam on the sample. To process the data, different softwares have been developed or updated. A first example on a decorated medieval shard highlights the perspectives of the technique

  17. A new mapping acquisition and processing system for simultaneous PIXE-RBS analysis with external beam

    The combination of ion beam analysis techniques is particularly fruitful for the study of cultural heritage objects. For several years, the AGLAE facility of the Louvre laboratory has been implementing these techniques with an external beam. The recent set-up permits to carry out PIXE, PIGE and RBS simultaneously on the same analyzed spot with a particle beam of approximately 20 μm diameter. A new mapping system has been developed in order to provide elemental concentration maps from the PIXE and RBS spectra. This system combines the Genie2000 spectroscopy software with a homemade software that creates maps by handling acquisition with the object position. Each pixel of each PIXE and RBS maps contains the spectrum normalised by the dose. After analysing each pixel of the PIXE maps (low and high energy X-ray spectra) with the Gupixwin peak-fitting software, quantitative elemental concentrations are obtained for the major and trace elements. This paper presents the quantitative elemental maps extracted from the PIXE spectra and the development of RBS data processing for light element distribution and thin layer characterization. Examples on rock painting and lustrous ceramics will be presented.

  18. A new mapping acquisition and processing system for simultaneous PIXE-RBS analysis with external beam

    Pichon, L., E-mail: laurent.pichon@culture.gouv.f [Centre de recherche et de restauration des musees de France (C2RMF), Palais du Louvre -14 quai Francois Mitterrand, 75001 Paris (France); Beck, L.; Walter, Ph.; Moignard, B.; Guillou, T. [Centre de recherche et de restauration des musees de France (C2RMF), Palais du Louvre -14 quai Francois Mitterrand, 75001 Paris (France)

    2010-06-15

    The combination of ion beam analysis techniques is particularly fruitful for the study of cultural heritage objects. For several years, the AGLAE facility of the Louvre laboratory has been implementing these techniques with an external beam. The recent set-up permits to carry out PIXE, PIGE and RBS simultaneously on the same analyzed spot with a particle beam of approximately 20 {mu}m diameter. A new mapping system has been developed in order to provide elemental concentration maps from the PIXE and RBS spectra. This system combines the Genie2000 spectroscopy software with a homemade software that creates maps by handling acquisition with the object position. Each pixel of each PIXE and RBS maps contains the spectrum normalised by the dose. After analysing each pixel of the PIXE maps (low and high energy X-ray spectra) with the Gupixwin peak-fitting software, quantitative elemental concentrations are obtained for the major and trace elements. This paper presents the quantitative elemental maps extracted from the PIXE spectra and the development of RBS data processing for light element distribution and thin layer characterization. Examples on rock painting and lustrous ceramics will be presented.

  19. A Randomized Multicentre Phase II Trial Comparing Adjuvant Therapy in Patients with Interferon Alpha-2b and 5-FU Alone or in Combination with Either External Radiation Treatment and Cisplatin (CapRI) or Radiation alone regarding Event-Free Survival – CapRI-2

    The 5-year survival of patients with resected pancreatic adenocarcinoma is still unsatisfying. The ESPAC-1 and the CONKO 001 trial proofed that adjuvant chemotherapy improves 5-year survival significantly from approximately 14% to 21%. In parallel, investigators from the Virginia Mason Clinic reported a 5-year survival rate of 55% in a phase II trial evaluating a combination of adjuvant chemotherapy, immunotherapy and external beam radiation (CapRI-scheme). Two other groups confirmed in phase II trials these results to a certain extent. However, these groups reported severe gastrointestinal toxicity (up to 93% grade 3 or 4 toxicity). In a randomized controlled phase III trial, called CapRI, 110 patients were enrolled from 2004 to 2007 in Germany and Italy to check for reproducibility. Interestingly, much less gastrointestinal toxicity was observed. However, dose-reduction due to haematological side effects had to be performed in nearly all patients. First clinical results are expected for the end of 2009. CapRI-2 is an open, controlled, prospective, randomized, multicentre phase II trial with three parallel arms. A de-escalation of the CapRI-scheme will be tested in two different modifications. Patients in study arm A will be treated as outpatients with the complete CapRI-scheme consisting of cisplatin, Interferon alpha-2b and external beam radiation and three cycles of 5-fluorouracil continuous infusion. In study arm B the first de-escalation will be realised by omitting cisplatin. Next, patients in study arm C will additionally not receive external beam radiation. A total of 135 patients with pathologically confirmed R0 or R1 resected pancreatic adenocarcinoma are planned to be enrolled. Primary endpoint is the comparison of the treatment groups with respect to six-month event-free-survival. An event is defined as grade 3 or grade 4 toxicity, objective tumour recurrence, or death. The aim of this clinical trial is to evaluate de-escalation of the CapRI-scheme. It

  20. Burnout experiments on the externally-finned swirl tube for steady-state and high-heat flux beam stops

    An experimental study to develop beam stops for the next generation of neutral beam injectors was started, using an ion source developed for the JT-60 neutral beam injector. A swirl tube is one of the most promising candidates for a beam stop element which can handle steady-state and high-heat flux beams. In the present experiments, a modified swirl tube, namely an externally-finned swirl tube, was tested together with a simple smooth tube, an externally finned tube, and an internally finned tube. The major dimensions of the tubes are 10 mm in outer-diameter, 1.5 mm in wall thickness, 15 mm in external fin width, and 700 mm in length. The burnout heat flux (CHF) normal to the externally finned swirl tube was 4.1±0.1 kW/cm2, where the Gaussian e-folding half-width of the beam intensity distribution was about 90 mm, the flow rate of the cooling water was 30 l/min, inlet and outlet gauge pressures were about 1 MPa and 0.2 MPa, respectively, and the temperature of the inlet water was kept to 200C during a pulse. A burnout heat flux ratio, which is defined by the ratio of the CHF value of the externally-finned swirl tube to that of the externally-finned tube, turned out to be about 1.5. Burnout heat fluxes of the tubes with a swirl tape or internal fins increase linearly with an increase of the flow rate. It was found that the tube with external fins has effects that not only reduce the thermal stress but also improve the characteristics of boiling heat transfer. (orig.)

  1. Injectable silver nanosensors: in vivo dosimetry for external beam radiotherapy using positron emission tomography

    Christensen, A. N.; Rydhög, J. S.; Søndergaard, R. V.; Andresen, T. L.; Holm, S.; Munck Af Rosenschöld, P.; Conradsen, K.; Jølck, R. I.

    2016-05-01

    Development of safe and efficient radiotherapy routines requires quantification of the delivered absorbed dose to the cancer tissue in individual patients. In vivo dosimetry can provide accurate information about the absorbed dose delivered during treatment. In the current study, a novel silver-nanosensor formulation based on poly(vinylpyrrolidinone)-coated silver nanoparticles formulated in a gelation matrix composed of sucrose acetate isobutyrate has been developed for use as an in vivo dosimeter for external beam radiotherapy. In situ photonuclear reactions trigger the formation of radioactive 106Ag, which enables post treatment verification of the delivered dose using positron emission tomography imaging. The silver-nanosensor was investigated in a tissue equivalent thorax phantom using clinical settings and workflow for both standard fractionated radiotherapy (2 Gy) and stereotactic radiotherapy (10- and 22 Gy) in a high-energy beam setting (18 MV). The developed silver-nanosensor provided high radiopacity on the planning CT-scans sufficient for patient positioning in image-guided radiotherapy and provided dosimetric information about the absorbed dose with a 10% and 8% standard deviation for the stereotactic regimens, 10 and 22 Gy, respectively.Development of safe and efficient radiotherapy routines requires quantification of the delivered absorbed dose to the cancer tissue in individual patients. In vivo dosimetry can provide accurate information about the absorbed dose delivered during treatment. In the current study, a novel silver-nanosensor formulation based on poly(vinylpyrrolidinone)-coated silver nanoparticles formulated in a gelation matrix composed of sucrose acetate isobutyrate has been developed for use as an in vivo dosimeter for external beam radiotherapy. In situ photonuclear reactions trigger the formation of radioactive 106Ag, which enables post treatment verification of the delivered dose using positron emission tomography imaging. The

  2. Retina Pathology of a Failed External Beam-Radiated Group Vb Retinoblastoma

    Hsin-Yuan Tan

    2002-08-01

    Full Text Available We report on a 7-month-old boy who suffered from retinoblastoma with presentation ofa white pupillary reflex in his right eye. Initial examination showed a large subretinal andintraretinal mass nasally with extensive vitreous seeding of tumor cells (Group Vb in theReese-Ellsworth classification. External beam radiation therapy (EBRT was applied inhopes of preserving the eye, and significant regression with disappearance of vitreous seedingsand a prominently decreased tumor mass with localized calcification were documented.Unfortunately total retinal detachment was subsequently identified 3 months after irradiation.The patient ultimately underwent enucleation, and histopathology revealed significantcalcification within the residual tumor without marked necrosis; a preretinal fibrous membranewith focal vascular thickening was noted, which implied a partial but incompleteeffect of EBRT for this group Vb retinoblastoma. We describe the histopathological findingsof the failure of irradiation for a group Vb retinoblastoma, and emphasize the importance ofearly application of EBRT treatment for a retinoblastoma.

  3. Salvage brachytherapy for locally recurrent prostate cancer after external beam radiotherapy

    Yasuhiro Yamada

    2015-01-01

    Full Text Available External beam radiotherapy (EBRT is a standard treatment for prostate cancer. Despite the development of novel radiotherapy techniques such as intensity-modulated conformal radiotherapy, the risk of local recurrence after EBRT has not been obviated. Various local treatment options (including salvage prostatectomy, brachytherapy, cryotherapy, and high-intensity focused ultrasound [HIFU] have been employed in cases of local recurrence after primary EBRT. Brachytherapy is the first-line treatment for low-risk and selected intermediate-risk prostate tumors. However, few studies have examined the use of brachytherapy to treat post-EBRT recurrent prostate cancer. The purpose of this paper is to analyze the current state of our knowledge about the effects of salvage brachytherapy in patients who develop locally recurrent prostate cancer after primary EBRT. This article also introduces our novel permanent brachytherapy salvage method.

  4. Salvage brachytherapy for locally recurrent prostate cancer after external beam radiotherapy.

    Yamada, Yasuhiro; Okihara, Koji; Iwata, Tsuyoshi; Masui, Koji; Kamoi, Kazumi; Yamada, Kei; Miki, Tsuneharu

    2015-01-01

    External beam radiotherapy (EBRT) is a standard treatment for prostate cancer. Despite the development of novel radiotherapy techniques such as intensity-modulated conformal radiotherapy, the risk of local recurrence after EBRT has not been obviated. Various local treatment options (including salvage prostatectomy, brachytherapy, cryotherapy, and high-intensity focused ultrasound [HIFU]) have been employed in cases of local recurrence after primary EBRT. Brachytherapy is the first-line treatment for low-risk and selected intermediate-risk prostate tumors. However, few studies have examined the use of brachytherapy to treat post-EBRT recurrent prostate cancer. The purpose of this paper is to analyze the current state of our knowledge about the effects of salvage brachytherapy in patients who develop locally recurrent prostate cancer after primary EBRT. This article also introduces our novel permanent brachytherapy salvage method. PMID:26112477

  5. An examination of human factors in external beam radiation therapy: Findings and implications

    To better understand the contributing factors to human error in external beam radiation therapy, the US Nuclear Regulatory Commission has undertaken a series of human factors evaluations. A team of human factors specialists, assisted by a panel of radiation oncologists, medical physicists, and radiation technologists, conducted visits to 24 radiation oncology departments at community hospitals, university centers, and free-standing clinics. A function and task analysis was initially performed to guide subsequent evaluations in the areas of human-system interfaces, procedures, training and qualifications, and organizational policies and practices. Representative findings and implications for improvement are discussed within the context of a dynamic model which holds that misadministration likely results from the unanticipated interaction of several necessary but singly insufficient conditions

  6. Multiple idiopathic external and internal resorption: Case report with cone-beam computed tomography findings

    Celikten, Berkan; Uzuntas, Ceren Feriha; Kurt, Hakan [Faculty of Dentistry, Ankara University, Ankara (Turkmenistan)

    2014-12-15

    Root resorption is loss of dental hard tissue as a result of clastic activities. The dental hard tissue of permanent teeth does not normally undergo resorption, except in cases of inflammation or trauma. However, there are rare cases of tooth resorption of an unknown cause, known as 'idiopathic root resorption.' This report would discuss a rare case of multiple idiopathic resorption in the permanent maxillary and mandibular teeth of an otherwise healthy 36-year-old male patient. In addition to a clinical examination, the patient was imaged using conventional radiography and cone-beam computed tomography (CBCT). The examinations revealed multiple external and internal resorption of the teeth in all four quadrants of the jaws with an unknown cause. Multiple root resorption is a rare clinical phenomenon that should be examined using different radiographic modalities. Cross-sectional CBCT is useful in the diagnosis and examination of such lesions.

  7. Treatment of Head and Neck Paragangliomas With External Beam Radiation Therapy

    Purpose: To retrospectively assess the outcomes of radiation therapy in patients with head and neck paragangliomas. Methods and Materials: From 1990 to 2009, 66 patients with 81 head and neck paragangliomas were treated by conventional external beam radiation therapy in 25 fractions at a median dose of 45 Gy (range, 41.4-68 Gy). One case was malignant. The median gross target volume and planning target volume were 30 cm3 (range, 0.9-243 cm3) and 116 cm3 (range, 24-731 cm3), respectively. Median age was 57.4 years (range, 15-84 years). Eleven patients had multicentric lesions, and 8 had family histories of paraganglioma. Paragangliomas were located in the temporal bone, the carotid body, and the glomus vagal in 51, 18, and 10 patients, respectively. Forty-six patients had exclusive radiation therapy, and 20 had salvage radiation therapy. The median follow-up was 4.1 years (range, 0.1-21.2 years). Results: One patient had a recurrence of temporal bone paraganglioma 8 years after treatment. The actuarial local control rates were 100% at 5 years and 98.7% at 10 years. Patients with multifocal tumors and family histories were significantly younger (42 years vs 58 years [P=.002] and 37 years vs 58 years [P=.0003], respectively). The association between family predisposition and multifocality was significant (P<.001). Two patients had cause-specific death within the 6 months after irradiation. During radiation therapy, 9 patients required hospitalization for weight loss, nausea, mucositis, or ophthalmic zoster. Two late vascular complications occurred (middle cerebral artery and carotid stenosis), and 2 late radiation-related meningiomas appeared 15 and 18 years after treatment. Conclusion: Conventional external beam radiation therapy is an effective and safe treatment option that achieves excellent local control; it should be considered as a first-line treatment of choice for head and neck paragangliomas

  8. External beam radiotherapy for basal cell carcinoma. Local control and cosmetic outcome

    Background: The basal cell carcinoma which is often occurring in the elderly can be well treated by surgery. For large and recurrent lesions and in cosmetically difficult locations external beam radiotherapy provides an equally effective treatment alternative. Patients and Methods: From 1986 to 1999, 60 females and 39 males received primary radiotherapy for a total of 127 histologically verified basal cell carcinoma lesions. Tumors were mostly localized in the face at the temple, nose and forehead. Radiotherapy was applied with orthovoltage equipment and energies of up to 100 kV. Single doses ranged from 2 to 5 Gy related to the 80%-isodose depth. Weekly doses ranged from 8 to 25 Gy and total doses from 25 to 60 Gy. The mean follow-up period was 36±21 months. The acute sequelae were scored according to CTC criteria. Radiogenic late effects as single events were related to the radiation portal. Results: 3 months after treatment all besides one patient (99%) experienced complete tumor remission (CR). In all cases, acute radiation reaction occurred within the radiation portal: CTC Grade 1 in 100%, CTC Grade 2 in 54% and CTC Grade 3 in 30% of the cases. All side effects regressed under simple local measures without further complications. Late sequelae were observed in three cases. Overall cosmetic outcome was good to excellent in almost all patients (98%). In two cases (2%) a local recurrence was observed 6 and 20 months after radiotherapy. Conclusion: External beam (orthovoltage) radiotherapy is very effective and yields high tumor control rates and good cosmetic results in long-term follow-up. Former dermatological treatment concepts should be replaced by an ICRU-based radiophysical dose prescription and should respect the newer radiobiological fractionation principles. (orig.)

  9. Fractionated External Beam Radiotherapy as a Suitable Preparative Regimen for Hepatocyte Transplantation After Partial Hepatectomy

    Purpose: Hepatocyte transplantation is strongly considered to be a promising option to correct chronic liver failure through repopulation of the diseased organ. We already reported on extensive liver repopulation by hepatocytes transplanted into rats preconditioned with 25-Gy single dose selective external beam irradiation (IR). Herein, we tested lower radiation doses and fractionated protocols, which would be applicable in clinical use. Methods and Material: Livers of dipeptidylpeptidase IV (DPPIV)-deficient rats were preconditioned with partial liver external beam single dose IR at 25 Gy, 8 Gy, or 5 Gy, or fractionated IR at 5 x 5 Gy or 5 x 2 Gy. Four days after completion of IR, a partial hepatectomy (PH) was performed to resect the untreated liver section. Subsequently, 12 million wild-type (DPPIV+) hepatocytes were transplanted via the spleen into the recipient livers. The degree of donor cell integration and liver repopulation was studied 16 weeks after transplantation by means of immunofluorescence and DPPIV-luminescence assay. Results: Donor hepatocyte integration and liver repopulation were more effective in the irradiated livers following pretreatment with the IR doses 1 x 25 Gy and 5 x 5 Gy (formation of large DPPIV-positive cell clusters) than single-dose irradiation at 8 Gy or 5 Gy (DPPIV-positive clusters noticeably smaller and less frequent). Quantitative analysis of extracted DPPIV revealed signals exceeding the control level in all transplanted animals treated with IR and PH. Compared with the standard treatment of 1 x 25 Gy, fractionation with 5 x 5 Gy was equally efficacious, the Mann-Whitney U test disclosing no statistically significant difference (p = 0.146). The lower doses of 1 x 5 Gy, 1 x 8 Gy, and 5 x 2 Gy were significantly less effective with p < 0.05. Conclusion: This study suggests that fractionated radiotherapy in combination with PH is a conceivable pretreatment approach to prime the host liver for hepatocyte transplantation, thus

  10. External beam radiotherapy for subretinal neovascularization in age-related macular degeneration: is this treatment efficient?

    Purpose: Control of the natural course of sub retinal neovascularization (SRNV) in age-related macular degeneration (AMD) is difficult. Only a subset of patients is suitable for laser coagulation. This prospective study aimed to determine the efficacy and individual benefit of external beam radiotherapy (EBRT). Methods and Materials: The prospective trial included 287 patients with subfoveal neovascularization due to AMD which was verified by fluorescein angiography. Patients have been treated between January 1996 and October 1997. All patients received a total dose of 16 Gy in 2-Gy daily fractions with 5-6 MeV photons based on computerized treatment planning in individual head mask fixation. This first analysis is based on 73 patients (50 women, 23 men, median age 74.3 years), with a median follow-up of 13.3 months and a minimum follow-up of 11 months. Results: All patients completed therapy and tolerability was good. First clinical control with second angiography was performed 6 weeks after irradiation, then in 3-month intervals. Eighteen patients with SRNV refusing radiotherapy served as a control group and were matched with 18 irradiated patients. After 7 months median visual acuity (VA) was 20/160 for the irradiated and 20/400 for the untreated patients. One year after radiotherapy final median VA was 20/400 in both groups. Conclusion: These results suggest that 16 Gy of conventionally fractionated external beam irradiation slows down the visual loss in exudative AMD for only a few months. Patients' reading vision could not be saved for a long-term run

  11. Treatment of Head and Neck Paragangliomas With External Beam Radiation Therapy

    Dupin, Charles, E-mail: c.dupin@bordeaux.unicancer.fr [Department of Radiotherapy, Comprehensive Cancer Center, Institut Bergonié, Bordeaux (France); Lang, Philippe [Department of Radiotherapy, Pitié Salpétrière, Paris (France); Dessard-Diana, Bernadette [Department of Radiotherapy, Hopital Européen Georges Pompidou, Paris (France); Simon, Jean-Marc; Cuenca, Xavier; Mazeron, Jean-Jacques; Feuvret, Loïc [Department of Radiotherapy, Pitié Salpétrière, Paris (France)

    2014-06-01

    Purpose: To retrospectively assess the outcomes of radiation therapy in patients with head and neck paragangliomas. Methods and Materials: From 1990 to 2009, 66 patients with 81 head and neck paragangliomas were treated by conventional external beam radiation therapy in 25 fractions at a median dose of 45 Gy (range, 41.4-68 Gy). One case was malignant. The median gross target volume and planning target volume were 30 cm{sup 3} (range, 0.9-243 cm{sup 3}) and 116 cm{sup 3} (range, 24-731 cm{sup 3}), respectively. Median age was 57.4 years (range, 15-84 years). Eleven patients had multicentric lesions, and 8 had family histories of paraganglioma. Paragangliomas were located in the temporal bone, the carotid body, and the glomus vagal in 51, 18, and 10 patients, respectively. Forty-six patients had exclusive radiation therapy, and 20 had salvage radiation therapy. The median follow-up was 4.1 years (range, 0.1-21.2 years). Results: One patient had a recurrence of temporal bone paraganglioma 8 years after treatment. The actuarial local control rates were 100% at 5 years and 98.7% at 10 years. Patients with multifocal tumors and family histories were significantly younger (42 years vs 58 years [P=.002] and 37 years vs 58 years [P=.0003], respectively). The association between family predisposition and multifocality was significant (P<.001). Two patients had cause-specific death within the 6 months after irradiation. During radiation therapy, 9 patients required hospitalization for weight loss, nausea, mucositis, or ophthalmic zoster. Two late vascular complications occurred (middle cerebral artery and carotid stenosis), and 2 late radiation-related meningiomas appeared 15 and 18 years after treatment. Conclusion: Conventional external beam radiation therapy is an effective and safe treatment option that achieves excellent local control; it should be considered as a first-line treatment of choice for head and neck paragangliomas.

  12. Clinical evaluation of external beam radiotherapy combined with arterial infusion chemotherapy for advanced oral tongue cancer

    Clinical results of external beam radiotherapy combined with arterial infusion chemotherapy for advanced oral tongue cancer were analyzed. Forty patients with oral tongue squamous cell carcinoma underwent these combined therapy in the period between 1985 and 1996. Subject include 17 males and 23 females. Ages ranged from 27 to 84; median age was 64.2. The size of primary lesion was classified as follows: T1: 2 cases, T2: 16 cases, T3: 21 cases, T4: 1 case. Sixteen patients were treated as radical therapy, 24 as preoperative therapy. Anti-cancer drugs used for arterial infusion were 5-FU (31 patients) or CBDCA (9 patients). For 16 radical cases, ten (62.5%) were CR (tumor disappeared). In 4 cases (25.0%), tumor volume was decreased above 50%, but in 2 (12.5%) any local effect could not be confirmed. For 24 pre-operative cases, Complete Response (CR) was observed only in 12.5% (3 patients). Partial Response (PR) was observed in 15 patients (62.5%), no change (NC) in 6 (25.0%). In 6 from 15 PR cases disappearance of viable atypical cells could be confirmed from histological examinations of resected tongue. In results local control rate (CR rate) for 24 pre-operative cases was 37.5% (9/24). Severe complications, for examples ulcerations of the tongue or exposure of the mandible could not be found in any cases. CR was observed in 19 patients (47.5%) out of 40, and severe late complications were noted in no patients. External beam radiotherapy combined with arterial infusion chemotherapy was effective for locally advanced cancer of anterior two-thirds of the tongue. (author)

  13. Propagation characteristics of a focused laser beam in a strontium barium niobate photorefractive crystal under reverse external electric field.

    Guo, Q L; Liang, B L; Wang, Y; Deng, G Y; Jiang, Y H; Zhang, S H; Fu, G S; Simmonds, P J

    2014-10-01

    The propagation characteristics of a focused laser beam in a SBN:75 photorefractive crystal strongly depend on the signal-to-background intensity ratio (R=Is/Ib) under reverse external electric field. In the range 20>R>0.05, the laser beam shows enhanced self-defocusing behavior with increasing external electric field, while it shows self-focusing in the range 0.03>R>0.01. Spatial solitons are observed under a suitable reverse external electric field for R=0.025. A theoretical model is proposed to explain the experimental observations, which suggest a new type of soliton formation due to "enhancement" not "screening" of the external electrical field. PMID:25322227

  14. Accuracy of digital peripical radiography and cone-beam computed tomography in detecting external root resorption

    The purpose of this study was to evaluate and compare the efficacy of cone-beam computed tomography (CBCT) and digital intraoral radiography in diagnosing simulated small external root resorption cavities. Cavities were drilled in 159 roots using a small spherical bur at different root levels and on all surfaces. The teeth were imaged both with intraoral digital radiography using image plates and with CBCT. Two sets of intraoral images were acquired per tooth: orthogonal (PA) which was the conventional periapical radiograph and mesioangulated (SET). Four readers were asked to rate their confidence level in detecting and locating the lesions. Receiver operating characteristic (ROC) analysis was performed to assess the accuracy of each modality in detecting the presence of lesions, the affected surface, and the affected level. Analysis of variation was used to compare the results and kappa analysis was used to evaluate interobserver agreement. A significant difference in the area under the ROC curves was found among the three modalities (P=0.0002), with CBCT (0.81) having a significantly higher value than PA (0.71) or SET (0.71). PA was slightly more accurate than SET, but the difference was not statistically significant. CBCT was also superior in locating the affected surface and level. CBCT has already proven its superiority in detecting multiple dental conditions, and this study shows it to likewise be superior in detecting and locating incipient external root resorption

  15. Accuracy of digital peripical radiography and cone-beam computed tomography in detecting external root resorption

    Creanga, Adriana Gabriela [Division of Dental Diagnostic Science, Rutgers School of Dental Medicine, Newark (United States); Geha, Hassem; Sankar, Vidya; Mcmahan, Clyde Alex; Noujeim, Marcel [University of Texas Health Science Center San Antonio, San Antonio (United States); Teixeira, Fabrico B. [Dept. of Endodontics, University of Iowa, Iowa City (United States)

    2015-09-15

    The purpose of this study was to evaluate and compare the efficacy of cone-beam computed tomography (CBCT) and digital intraoral radiography in diagnosing simulated small external root resorption cavities. Cavities were drilled in 159 roots using a small spherical bur at different root levels and on all surfaces. The teeth were imaged both with intraoral digital radiography using image plates and with CBCT. Two sets of intraoral images were acquired per tooth: orthogonal (PA) which was the conventional periapical radiograph and mesioangulated (SET). Four readers were asked to rate their confidence level in detecting and locating the lesions. Receiver operating characteristic (ROC) analysis was performed to assess the accuracy of each modality in detecting the presence of lesions, the affected surface, and the affected level. Analysis of variation was used to compare the results and kappa analysis was used to evaluate interobserver agreement. A significant difference in the area under the ROC curves was found among the three modalities (P=0.0002), with CBCT (0.81) having a significantly higher value than PA (0.71) or SET (0.71). PA was slightly more accurate than SET, but the difference was not statistically significant. CBCT was also superior in locating the affected surface and level. CBCT has already proven its superiority in detecting multiple dental conditions, and this study shows it to likewise be superior in detecting and locating incipient external root resorption.

  16. The external beam facility used to characterize corrosion products in metallic statuettes

    Rizzutto, M.A. [Universidade de Sao Paulo, Instituto de Fisica, Rua do Matao Travessa R 187, 05508-900 Sao Paulo, SP (Brazil)]. E-mail: marcia.rizzutto@dfn.if.usp.br; Tabacniks, M.H. [Universidade de Sao Paulo, Instituto de Fisica, Rua do Matao Travessa R 187, 05508-900 Sao Paulo, SP (Brazil); Added, N. [Universidade de Sao Paulo, Instituto de Fisica, Rua do Matao Travessa R 187, 05508-900 Sao Paulo, SP (Brazil); Barbosa, M.D.L. [Universidade de Sao Paulo, Instituto de Fisica, Rua do Matao Travessa R 187, 05508-900 Sao Paulo, SP (Brazil); Curado, J.F. [Universidade de Sao Paulo, Instituto de Fisica, Rua do Matao Travessa R 187, 05508-900 Sao Paulo, SP (Brazil); Santos, W.A. [Universidade de Sao Paulo, Instituto de Fisica, Rua do Matao Travessa R 187, 05508-900 Sao Paulo, SP (Brazil); Lima, S.C. [Laboratorio de Conservacao e Restauracao, Museu de Arqueologia e Etnologia, Universidade de Sao Paulo, Av Prof. Almeida Prado, 1466, 05508-900 Sao Paulo, SP (Brazil); Melo, H.G. [Laboratorio de Eletroquimica e CorroSao, Departamento de Engenharia Quimica, Escola Politecnica, Universidade de Sao Paulo, Av. Luciano Gualberto, trav.3, n.380, 05508-900 Sao Paulo, SP (Brazil); Neiva, A.C. [Laboratorio de Eletroquimica e CorroSao, Departamento de Engenharia Quimica, Escola Politecnica, Universidade de Sao Paulo, Av. Luciano Gualberto, trav.3, n.380, 05508-900 Sao Paulo, SP (Brazil)

    2005-10-15

    To open new possibilities in nuclear applied physics research, mainly for the analysis of art objects in air, an external beam facility was installed at LAMFI (Laboratorio de Analise de Materiais por Feixes Ionicos) of University of Sao Paulo. PIXE measurements were made using an XR-100CR (Si-PIN) X-ray detector pointed to the sample mounted after an approximate 11 mm air path, hence with effective beam energy of 0.9 MeV. This setup was used to characterize the corrosion products of two ethnological metallic statuettes from the African collection of the Museum of Archaeology and Etnology. PIXE analysis of the corrosion free base of one statuette showed that Cu and Zn are the main components of the alloy, while Pb is present in smaller amount. The analysis of some corrosion products showed a Zn:Cu relationship higher than that of the base, evidencing selective corrosion. The main components of the other statuette were Cu and Pb, while S and Zn were found in smaller amounts.

  17. Multichannel Data Acquisition System comparison for Quality Assurance in external beam radiation therapy

    Megavoltage photon radiation therapies are widely used in modern cancer treatment. The improvement of the treatment has lead to the need of Quality Assurance (QA) devices to detect malfunctioning or human mistakes during the planning phase and treatment verification. Active electronic devices for 2D or 3D QA in external beam radiotherapy are typically based on analogue/digital mixed signal Data Acquisition Systems (DAS) which are required to have high spatial resolution, large dynamic range, high sensitivity, large numbers of channels and fast real-time capabilities. The Centre of Medical Radiation Physics (CMRP) has developed several multichannel DAS architectures based on different analogue front-ends to suit a wide range of radiotherapy applications. For the purpose of this study, two DAS, with different front-ends, have been equipped with 128 channels and tested in a clinical environment. Data show a good agreement within 1% between the two systems and the ionising chamber currently used for daily QA. - Highlights: • Two multichannels Data Acquisition Systems (DAS A and B) have been designed by the CMRP for Quality Assurance purposes. • The DAS have been tested and compared to ion chamber showing agreement of the results within 1%. • DAS have been used to characterise megavoltage LINAC beam profile and timing performances

  18. The external beam facility used to characterize corrosion products in metallic statuettes

    To open new possibilities in nuclear applied physics research, mainly for the analysis of art objects in air, an external beam facility was installed at LAMFI (Laboratorio de Analise de Materiais por Feixes Ionicos) of University of Sao Paulo. PIXE measurements were made using an XR-100CR (Si-PIN) X-ray detector pointed to the sample mounted after an approximate 11 mm air path, hence with effective beam energy of 0.9 MeV. This setup was used to characterize the corrosion products of two ethnological metallic statuettes from the African collection of the Museum of Archaeology and Etnology. PIXE analysis of the corrosion free base of one statuette showed that Cu and Zn are the main components of the alloy, while Pb is present in smaller amount. The analysis of some corrosion products showed a Zn:Cu relationship higher than that of the base, evidencing selective corrosion. The main components of the other statuette were Cu and Pb, while S and Zn were found in smaller amounts

  19. Injectable silver nanosensors: in vivo dosimetry for external beam radiotherapy using positron emission tomography.

    Christensen, A N; Rydhög, J S; Søndergaard, R V; Andresen, T L; Holm, S; Munck Af Rosenschöld, P; Conradsen, K; Jølck, R I

    2016-06-01

    Development of safe and efficient radiotherapy routines requires quantification of the delivered absorbed dose to the cancer tissue in individual patients. In vivo dosimetry can provide accurate information about the absorbed dose delivered during treatment. In the current study, a novel silver-nanosensor formulation based on poly(vinylpyrrolidinone)-coated silver nanoparticles formulated in a gelation matrix composed of sucrose acetate isobutyrate has been developed for use as an in vivo dosimeter for external beam radiotherapy. In situ photonuclear reactions trigger the formation of radioactive (106)Ag, which enables post treatment verification of the delivered dose using positron emission tomography imaging. The silver-nanosensor was investigated in a tissue equivalent thorax phantom using clinical settings and workflow for both standard fractionated radiotherapy (2 Gy) and stereotactic radiotherapy (10- and 22 Gy) in a high-energy beam setting (18 MV). The developed silver-nanosensor provided high radiopacity on the planning CT-scans sufficient for patient positioning in image-guided radiotherapy and provided dosimetric information about the absorbed dose with a 10% and 8% standard deviation for the stereotactic regimens, 10 and 22 Gy, respectively. PMID:27174233

  20. Experimental Study of the Effect of External Signal on Microwave Oscillations in a Nonrelativistic Electron Beam with Virtual Cathode

    Kalinin, Y; Kalinin, Yurij; Hramov, Alexander

    2006-01-01

    The effect of an external harmonic signal on the characteristics of microwave generation in a nonrelativistic electron beam with virtual cathode (VC) formed in a static retarding electric field (low-voltage vircator system) has been experimentally studied. A significant increase in the vircator generation power is observed when the frequency of the external signal is close to the frequency of VC oscillations. At large detunings, a broadband chaotic generation is observed.

  1. Optimum location of external markers using feature selection algorithms for real-time tumor tracking in external-beam radiotherapy: a virtual phantom study.

    Nankali, Saber; Esmaili Torshabi, Ahmad; Samadi Miandoab, Payam; Baghizadeh, Amin

    2016-01-01

    In external-beam radiotherapy, using external markers is one of the most reliable tools to predict tumor position, in clinical applications. The main challenge in this approach is tumor motion tracking with highest accuracy that depends heavily on external markers location, and this issue is the objective of this study. Four commercially available feature selection algorithms entitled 1) Correlation-based Feature Selection, 2) Classifier, 3) Principal Components, and 4) Relief were proposed to find optimum location of external markers in combination with two "Genetic" and "Ranker" searching procedures. The performance of these algorithms has been evaluated using four-dimensional extended cardiac-torso anthropomorphic phantom. Six tumors in lung, three tumors in liver, and 49 points on the thorax surface were taken into account to simulate internal and external motions, respectively. The root mean square error of an adaptive neuro-fuzzy inference system (ANFIS) as prediction model was considered as metric for quantitatively evaluating the performance of proposed feature selection algorithms. To do this, the thorax surface region was divided into nine smaller segments and predefined tumors motion was predicted by ANFIS using external motion data of given markers at each small segment, separately. Our comparative results showed that all feature selection algorithms can reasonably select specific external markers from those segments where the root mean square error of the ANFIS model is minimum. Moreover, the performance accuracy of proposed feature selection algorithms was compared, separately. For this, each tumor motion was predicted using motion data of those external markers selected by each feature selection algorithm. Duncan statistical test, followed by F-test, on final results reflected that all proposed feature selection algorithms have the same performance accuracy for lung tumors. But for liver tumors, a correlation-based feature selection algorithm, in

  2. SU-E-T-578: MCEBRT, A Monte Carlo Code for External Beam Treatment Plan Verifications

    Chibani, O; Ma, C [Fox Chase Cancer Center, Philadelphia, PA (United States); Eldib, A [Fox Chase Cancer Center, Philadelphia, PA (United States); Al-Azhar University, Cairo (Egypt)

    2014-06-01

    Purpose: Present a new Monte Carlo code (MCEBRT) for patient-specific dose calculations in external beam radiotherapy. The code MLC model is benchmarked and real patient plans are re-calculated using MCEBRT and compared with commercial TPS. Methods: MCEBRT is based on the GEPTS system (Med. Phys. 29 (2002) 835–846). Phase space data generated for Varian linac photon beams (6 – 15 MV) are used as source term. MCEBRT uses a realistic MLC model (tongue and groove, rounded ends). Patient CT and DICOM RT files are used to generate a 3D patient phantom and simulate the treatment configuration (gantry, collimator and couch angles; jaw positions; MLC sequences; MUs). MCEBRT dose distributions and DVHs are compared with those from TPS in absolute way (Gy). Results: Calculations based on the developed MLC model closely matches transmission measurements (pin-point ionization chamber at selected positions and film for lateral dose profile). See Fig.1. Dose calculations for two clinical cases (whole brain irradiation with opposed beams and lung case with eight fields) are carried out and outcomes are compared with the Eclipse AAA algorithm. Good agreement is observed for the brain case (Figs 2-3) except at the surface where MCEBRT dose can be higher by 20%. This is due to better modeling of electron contamination by MCEBRT. For the lung case an overall good agreement (91% gamma index passing rate with 3%/3mm DTA criterion) is observed (Fig.4) but dose in lung can be over-estimated by up to 10% by AAA (Fig.5). CTV and PTV DVHs from TPS and MCEBRT are nevertheless close (Fig.6). Conclusion: A new Monte Carlo code is developed for plan verification. Contrary to phantombased QA measurements, MCEBRT simulate the exact patient geometry and tissue composition. MCEBRT can be used as extra verification layer for plans where surface dose and tissue heterogeneity are an issue.

  3. Preparation Of Thermoluminescence Dosimeters For External Radiotherapy Beam Audit In Malaysia

    The external beam audit is a part of the Quality Assurance Programme (QAP) in radiotherapy that should be carried out to check the accuracy of dose delivered by the radiotherapy treatment units are within the tolerance limit of A ± 5 % as recommended by the International Commission of Radiation Units and Measurements (ICRU) Report No. 24. In this work, thermoluminescence dosimeters (TLD) in powder form were chosen to be used in the dose quality audit for the radiotherapy treatment units in Malaysia. As a preparation, the characterizations of a new batch of TLD-100 powders were studied. The studies include checks for the response of TLD-100 before and after pre-annealing process, reproducibility and linearity of TL signal. Results show that the response of TLD-100 powder after pre-annealing increases by 65 % compared with before pre-annealing process. These TLD-100 powders also provide reliable and consistent readings for the absorbed dose to water within the range of 150 cGy to 250 cGy with the maximum standard uncertainty of 0.554 μC. Finally, the calibration curves for 6 MV and 10 MV photon beams were established. These curves will be used in determining the absorbed dose to water (Dw) from user's irradiated TLDs. The expanded uncertainty (coverage factor k=2) of Dw determination was estimated to be 4.1 %. As a conclusion, these TLD-100 powders are ready to be used as a transfer detector for evaluating the accuracy of user's delivery dose in the radiotherapy beam audit program in Malaysia. (author)

  4. Optical tomographic in-air scanner for external radiation beam 3D gel dosimetry

    Full text: Optical CT scanners are used to measure 3D radiation dose distributions in radiosensitive gels. For radiotherapy dose verification, 3D dose measurements are useful for verification of complex linear accelerator treatment planning and delivery techniques. Presently optical CTs require the use of a liquid bath to match the refractive index of the gel to minimise refraction of the light rays leading to distortion and artifacts. This work aims to develop a technique for scanning gel samples in free-air, without the requirement for a matching liquid bath. The scanner uses a He-Ne laser beam, fanned across the acrylic cylindrical gel container by a rotating mirror. The gel container was designed to produce parallel light ray paths through the gel. A pin phantom was used to quantify geometrical distortion of the reconstructed image, while uniform field exposures were used to consider noise, uniformity and artifacts. Small diameter wires provided an indication of the spatial resolution of the scanner. Pin phantom scans show geometrical distortion comparable to scanners using matching fluid baths. Noise, uniformity and artifacts were not found to be major limitations for this scanner approach. Spatial resolution was limited by laser beam spot size, typically 0.4 mm full width half maximum. A free-air optical CT scanner has been developed with the advantage of scanning without a matching fluid bath. Test results show it has potential to provide suitable quality 3D dosimetry measurements for external beam dose verification, while offering significant advantages in convenience and efficiency for routine use.

  5. External beam milli-PIXE as analytical tool for Neolithic obsidian provenance studies

    Constantinescu, B.; Cristea-Stan, D. [National Institute for Nuclear Physics and Engineering Horia Hulubei, Bucharest-Magurele (Romania); Kovács, I.; Szõkefalvi-Nagy, Z. [Wigner Research Centre for Phyics, Institute for Particle and Nuclear Physics, Budapest (Hungary)

    2013-07-01

    Full text: Obsidian is the most important archaeological material used for tools and weapons before metals appearance. Its geological sources are limited and concentrated in few geographical zones: Armenia, Eastern Anatolia, Italian Lipari and Sardinia islands, Greek Melos and Yali islands, Hungarian and Slovak Tokaj Mountains. Due to this fact, in Mesolithic and Neolithic periods obsidian was the first archaeological material intensively traded even at long distances. To determine the geological provenance of obsidian and to identify the prehistoric long-range trade routes and possible population migrations elemental concentration ratios can help a 101, since each geological source has its 'fingerprints'. In this work external milli-PIXE technique was applied for elemental concentration ratio determinations in some Neolithic tools found in Transylvania and in the lron Gales region near Danube, and on few relevant geological samples (Slovak Tokaj Mountains, Lipari,Armenia). In Transylvania (the North-Western part of Romania, a region surrounded by Carpathian Mountains), Neolithic obsidian tools were discovered mainly in three regions: North-West - Oradea (near the border with Hungary, Slovakia and Ukraine), Centre -Cluj and Southwest- Banat (near the border with Serbia). A special case is lron Gales - Mesolithic and Early Neolithic sites, directly related to the appearance of agriculture replacing the Mesolithic economy based on hunting and fishing. Three long-distance trade routes could be considered: from Caucasus Mountains via North of the Black Sea, from Greek islands or Asia Minor via ex-Yugoslavia area or via Greece-Bulgaria or from Central Europe- Tokaj Mountains in the case of obsidian. As provenance 'fingerprints', we focused on Ti to Mn, and Rb-Sr-Y-Zr ratios. The measurements were performed at the external milli-PIXE beam-line of the 5MV VdG accelerator of the Wigner RCP. Proton energy of 3MeV and beam currents in the range of 1 ±1 D

  6. Evolution of gas-dynamical parameters of an electron beam in an inhomogeneous plasma with an external electric field

    The effects of density gradient and an externally applied electric field on the evolution of gas-dynamical parameters of an electron beam are investigated. The parameters include the height of the plateau in the beam distribution function in velocity space, its upper velocity boundary and the local velocity spread of the beam. It is shown that in a plasma with both decreasing density and uniform electric field, the gas-dynamical parameters are determined by the competing effects of density gradient and electric field, and the evolution of parameters is not self-similar.

  7. Evolution of gas-dynamical parameters of an electron beam in an inhomogeneous plasma with an external electric field

    Khalilpour, H [Physics Department, Payame Noor University, 19395-4697 Tehran (Iran, Islamic Republic of); Foroutan, G [Department of Physics, Faculty of Science, Sahand University of Technology, 51335-1996 Tabriz (Iran, Islamic Republic of); Li, B; Robinson, P A, E-mail: h_khalilpour@pnu.ac.ir [School of Physics, The University of Sydney, Sydney, NSW 2006 (Australia)

    2011-06-01

    The effects of density gradient and an externally applied electric field on the evolution of gas-dynamical parameters of an electron beam are investigated. The parameters include the height of the plateau in the beam distribution function in velocity space, its upper velocity boundary and the local velocity spread of the beam. It is shown that in a plasma with both decreasing density and uniform electric field, the gas-dynamical parameters are determined by the competing effects of density gradient and electric field, and the evolution of parameters is not self-similar.

  8. Dramatic response of follicular thyroid carcinoma with superior vena cava syndrome and tracheal obstruction to external-beam radiotherapy

    Wilford, M.R.; Chertow, B.S.; Lepanto, P.B.; Leidy, J.W. Jr. (Section of Endocrinology, Marshall University School of Medicine, Huntington, West Virginia (USA))

    1991-06-01

    We report a patient with follicular thyroid carcinoma progressing to superior vena cava (SVC) syndrome and tracheal obstruction despite multiple doses of radioactive iodine therapy but subsequently responding dramatically to external-beam radiotherapy (RT). Although RT is not considered to be the treatment of choice for follicular carcinoma, RT in our patient produced unequivocal improvement of SVC syndrome and tracheal obstruction.

  9. Effect of external magnetic field on critical current for the onset of virtual cathode oscillations in relativistic electron beams

    Hramov, Alexander; Koronovskii, Alexey; Morozov, Mikhail; Mushtakov, Alexander

    2008-02-01

    In this Letter we research the space charge limiting current value at which the oscillating virtual cathode is formed in the relativistic electron beam as a function of the external magnetic field guiding the beam electrons. It is shown that the space charge limiting (critical) current decreases with growth of the external magnetic field, and that there is an optimal induction value of the magnetic field at which the critical current for the onset of virtual cathode oscillations in the electron beam is minimum. For the strong external magnetic field the space charge limiting current corresponds to the analytical relation derived under the assumption that the motion of the electron beam is one-dimensional [D.J. Sullivan, J.E. Walsh, E. Coutsias, in: V.L. Granatstein, I. Alexeff (Eds.), Virtual Cathode Oscillator (Vircator) Theory, in: High Power Microwave Sources, vol. 13, Artech House Microwave Library, 1987, Chapter 13]. Such behavior is explained by the characteristic features of the dynamics of electron space charge in the longitudinal and radial directions in the drift space at the different external magnetic fields.

  10. Effect of external magnetic field on critical current for the onset of virtual cathode oscillations in relativistic electron beams

    Hramov, Alexander [Faculty of Nonlinear Processes, Saratov State University, Astrakhanskaya 83, Saratov 410012 (Russian Federation)], E-mail: aeh@nonlin.sgu.ru; Koronovskii, Alexey; Morozov, Mikhail; Mushtakov, Alexander [Faculty of Nonlinear Processes, Saratov State University, Astrakhanskaya 83, Saratov 410012 (Russian Federation)

    2008-02-04

    In this Letter we research the space charge limiting current value at which the oscillating virtual cathode is formed in the relativistic electron beam as a function of the external magnetic field guiding the beam electrons. It is shown that the space charge limiting (critical) current decreases with growth of the external magnetic field, and that there is an optimal induction value of the magnetic field at which the critical current for the onset of virtual cathode oscillations in the electron beam is minimum. For the strong external magnetic field the space charge limiting current corresponds to the analytical relation derived under the assumption that the motion of the electron beam is one-dimensional [D.J. Sullivan, J.E. Walsh, E. Coutsias, in: V.L. Granatstein, I. Alexeff (Eds.), Virtual Cathode Oscillator (Vircator) Theory, in: High Power Microwave Sources, vol. 13, Artech House Microwave Library, 1987, Chapter 13]. Such behavior is explained by the characteristic features of the dynamics of electron space charge in the longitudinal and radial directions in the drift space at the different external magnetic fields.

  11. Determining DVH parameters for combined external beam and brachytherapy treatment: 3D biological dose adding for patients with cervical cancer

    J.B. van de Kamer; A.A.C. de Leeuw; M.A. Moerland; I.M. Jürgenliemk-Schulz

    2010-01-01

    Purpose: To compare two methods of DVH parameter determination for combined external beam and brachytherapy treatment of cervical cancer. Materials and methods: Clinical treatment plans from five patients were used in this study. We simulated two applications given with PDR (32 x 60 cGy per applicat

  12. The Outcome of Conventional External Beam Radiotherapy for Patients with Squamous Cell Carcinoma of the Esophagus

    The best treatment for advanced esophageal cancer is chemoradiotherapy followed by surgery. In spite of the advance of multimodality therapy, most patients with esophageal cancer are treated with radiation therapy alone. This study reports the outcome of the use of conventional external beam radiotherapy alone for the treatment of esophageal cancer. Between January 1998 and December 2005, 30 patients with squamous cell carcinoma of the esophagus were treated with external beam radiotherapy using a total dose exceeding 40 Gy. Radiotherapy was delivered with a total dose of 44-60 Gy (median dose, 57.2 Gy) over 36 ∼115 days (median time, 45 days). Thirteen patients (43.3%) had a history of disorders such as diabetes, hypertension, tuberculosis, lye stricture, asthma, cerebral infarct, and cancers. Four patients metachronously had double primary cancers. The most common location of a tumor was the mid-thoracic portion of the esophagus (56.7%). Tumor lengths ranged from 2 cm to 11 cm, with a median length of 6 cm. For AJCC staging, stage III was the most common (63.3%). Five patients had metastases at diagnosis. The median overall survival was 8.3 months. The survival rates at 1-year and 2-years were 33.3% and 18.7%, respectively. The complete response rate 1∼3 months after radiotherapy was 20% (6/30) and the partial response rate was 70% (21/30). Sixteen patients (53.3%) had an improved symptom of dysphagia. Significant prognostic factors were age, tumor length, stage, degree of dysphagia at the time of diagnosis and tumor response. Cox regression analysis revealed the aim of treatment, clinical tumor response and tumor length as independent prognostic factors for overall survival. Twenty-eight patients had local failure and another four patients had metastases. Three patients were detected with double primary cancers in this analysis. A complication of esophageal stricture was observed in three patients (10%), and radiation pneumonitis occurred in two patients (6

  13. A criterion-based audit of the technical quality of external beam radiotherapy for prostate cancer

    Purpose: To evaluate the technical quality of external beam radiotherapy for prostate cancer in Canada. Methods: This was a multi-institution, retrospective study of a random sample of patients undergoing radiotherapy (RT) for prostate cancer in Canada. Patterns of care were determined by abstracting details of the patients’ management from original records. The quality of patient’s technical care was measured against a previously published, comprehensive suite of quality indicators. Results: 32 of the 37 RT centres participated. The total study population of 810 patients included 25% low-risk, 44% intermediate-risk, and 28% high-risk cases. 649 received external beam RT (EBRT) only, for whom compliance with 12 indicators of the quality of pre-treatment assessment ranged from 56% (sexual function documented) to 96% (staging bone scan obtained in high-risk patients). Compliance with treatment-related indicators ranged from 78% (dose to prostate ⩾74 Gy in intermediate risk patients not receiving hormone therapy) to 100% (3DCRT or IMRT plan). Compliance varied among centres; no centre demonstrated 100% compliance on all indicators and every centre was 100% compliant on at least some indicators. The number of assessment-related indicators (n = 13) with which a given centre was 100% compliant ranged from 4 to 11 (median 7) and the number of the treatment-specific indicators (n = 8) with which a given centre was 100% compliant ranged from 6 to 8 (median 8). ADT therapy was utilised in most high-risk cases (191, 92.3%). Conclusions: While patterns of prostate cancer care in Canada vary somewhat, compliance on the majority of quality indicators is very high. However, all centres showed room for improvement on several indicators and few individual patients received care that met target benchmarks on all quality measures. This variation is particularly important for indicators such as delivered dose where impact on disease outcome is known to exist, and suggests that

  14. Urinary incontinence in prostate cancer patients treated with external beam radiotherapy

    Background and purpose: To describe the incidence of urinary incontinence among prostate cancer patients treated with external beam radiotherapy (RT) and to investigate associated risk factors. Patients and methods: One thousand and hundred ninety-two patients with ≥24 months follow-up were the subjects of this series. All patients received between 50 and 72 Gy in 20-37 fractions (median 66 Gy/33). Post-RT urinary incontinence was scored by direct patient interviewing according to the modified RTOG/SOMA scale: Grade 1-occasional use of incontinence pads, Grade 2-intermittent use of incontinence pads, Grade 3-persistent use of incontinence pads, and Grade 4-permanent catheter. Risk-factors investigated were: age, diabetes, TURP prior to RT, elapsed time from TURP to RT, clinical stage, RT dose and presence of Grade ≥2 acute GU and GI toxicity. Non-parametric, actuarial univariate (Kaplan-Meier) and multivariate tests (MVA, Cox regression) were performed. Results: Median follow-up for the group is 52 months (24-109). Thirty-four patients (2.9%) had incontinence prior to RT, which was more common in TURP patients (7.8% vs 1.6% P<0.001). These are excluded from further analysis. Fifty-seven patients (4.9%) developed Grade 1 incontinence, 7 (0.6%) Grade 2, and 7 (0.6%) Grade 3. There was no Grade 4 incontinence. Actuarial rates for Grade ≥1 and ≥2 incontinence at 5 years are 7 and 1.7%, respectively. Risk factors on MVA associated with the development of Grade 1 or worse incontinence are pre-RT TURP (5-year rates 10% vs 6%, P=0.026), presence of Grade ≥2 acute GU toxicity (5-year rates 11% vs 5%, P=0.002). Age, diabetes, clinical stage, elapsed time from TURP to RT, RT dose or fraction size, acute GI toxicity were not significant. Patients who underwent post-RT TURP or dilatation for obstructive symptoms (4.3%), were more likely to develop Grade 2-3 incontinence (5-year rate 8 vs 1.5%, P=0.0015). Conclusions: Grade 2 or greater urinary incontinence is rare

  15. Investigation of the chaotic dynamics of an electron beam with a virtual cathode in an external magnetic field

    Egorov, E. N.; Hramov, A. E.

    2006-08-01

    The effect of the strength of the focusing magnetic field on chaotic dynamic processes occurring in an electron beam with a virtual cathode, as well as on the processes whereby the structures form in the beam and interact with each other, is studied by means of two-dimensional numerical simulations based on solving a self-consistent set of Vlasov-Maxwell equations. It is shown that, as the focusing magnetic field is decreased, the dynamics of an electron beam with a virtual cathode becomes more complicated due to the formation and interaction of spatiotemporal longitudinal and transverse structures in the interaction region of a vircator. The optimum efficiency of the interaction of an electron beam with the electromagnetic field of the vircator is achieved at a comparatively weak external magnetic field and is determined by the fundamentally two-dimensional nature of the motion of the beam electrons near the virtual cathode.

  16. Radiation safety assessment of cobalt 60 external beam radiotherapy using the risk-matrix method

    External beam radiotherapy is the only practice in which humans are placed directly in a radiation beam with the intention to deliver a very high dose. This is why safety in radiotherapy is very critical, and is a matter of interest to both radiotherapy departments and regulatory bodies. Accidental exposures have occurred throughout the world, thus showing the need for systematic safety assessments, capable to identify preventive measures and to minimize consequences of accidental exposure. Risk-matrix is a systematic approach which combines the relevant event features to assess the overall risk of each particular event. Once an event sequence is identified, questions such as how frequent the event, how severe the potential consequences and how reliable the existing safety measures are answered in a risk-matrix table. The ultimate goal is to achieve that the overall risk for events with severe consequences should always be low o very low. In the present study, the risk-matrix method has been applied to an hypothetical radiotherapy department, which could be equivalent to an upper level hospital of the Ibero American region, in terms of safety checks and preventive measures. The application of the method has identified 76 event sequences and revealed that the hypothetical radiotherapy department is sufficiently protected (low risk) against them, including 23 event sequences with severe consequences. The method has revealed that the risk of these sequences could grow to high level if certain specific preventive measures were degraded with time. This study has identified these preventive measures, thus facilitating a rational allocation of resources in regular controls to detect any loss of reliability. The method has proven to have an important practical value and is affordable at hospital level. The elaborated risk-matrix can be easily adapted to local circumstances, in terms of existing controls and safety measures. This approach can help hospitals to identify

  17. Peripheral photon and neutron doses from prostate cancer external beam irradiation.

    Bezak, Eva; Takam, Rundgham; Marcu, Loredana G

    2015-12-01

    Peripheral photon and neutron doses from external beam radiotherapy (EBRT) are associated with increased risk of carcinogenesis in the out-of-field organs; thus, dose estimations of secondary radiation are imperative. Peripheral photon and neutron doses from EBRT of prostate carcinoma were measured in Rando phantom. (6)LiF:Mg,Cu,P and (7)LiF:Mg,Cu,P glass-rod thermoluminescence dosemeters (TLDs) were inserted in slices of a Rando phantom followed by exposure to 80 Gy with 18-MV photon four-field 3D-CRT technique. The TLDs were calibrated using 6- and 18-MV X-ray beam. Neutron dose equivalents measured with CR-39 etch-track detectors were used to derive readout-to-neutron dose conversion factor for (6)LiF:Mg,Cu,P TLDs. Average neutron dose equivalents per 1 Gy of isocentre dose were 3.8±0.9 mSv Gy(-1) for thyroid and 7.0±5.4 mSv Gy(-1) for colon. For photons, the average dose equivalents per 1 Gy of isocentre dose were 0.2±0.1 mSv Gy(-1) for thyroid and 8.1±9.7 mSv Gy(-1) for colon. Paired (6)LiF:Mg,Cu,P and (7)LiF:Mg,Cu,P TLDs can be used to measure photon and neutron doses simultaneously. Organs in close proximity to target received larger doses from photons than those from neutrons whereas distally located organs received higher neutron versus photon dose. PMID:25564673

  18. Volume and dose specification for reporting external beam therapy (the ICRU recommendations)

    The International Commission on Radiation Units and Measurements (ICRU) has published the Report 50 ''Prescribing, Recording and Reporting Photon Beam Therapy'' (1993). The aim of the Report is to promote the use of a common set of definitions and concepts for specifying and reporting the doses in radiation therapy, as well as the volumes in which they are prescribed and delivered. Different volumes need to be identified prior to treatment planning: the gross tumour volume (GTV) and the clinical target volume (CTV). The planning target volume (PTV) is defined for treatment planning. The treated volume and the irradiated volume are identified when the treatment techniques and irradiation plan have been decided upon. As a general recommendation, the dose at, or near, the centre of the PTV, as well as the maximum and the minimum dose, shall be reported. Additional information when clinically relevant and available, should also be reported. The system of recommendations for reporting dose is based on the selection of a point within the PTV, which is referred to as the ICRU Reference Point. The ICRU Reference Point is selected firstly at the centre, or in the central part, of the PTV, and secondly on, or near, the central axes of the beams. A certain degree of inhomogeneity of the absorbed dose throughout the PTV cannot be avoided. Therefore, as a basic requirement, the best estimate of the maximum dose and the minimum dose to the PTV shall be reported together with the dose at the ICRU Reference Point. These 3 dose values then indicate the dose profile within the PTV. ICRU Report 50 allows for reporting basic data for all treatments at any level of complexity for absorbed dose computation. It also allows for reporting additional clinical and relevant data obtained by sophisticated methods. The recommendations are thus applicable to all external radiotherapy procedures. (author)

  19. Secondary external-beam radiotherapy and hyperthermia for local recurrence after 125-iodine implantation in adenocarcinoma of the prostate

    At Standford, six patients underwent a course of external radiotherapy after local recurrence following 125-iodine implantation. Four of the six patients also received concomitant hyperthermia. Four patients were initially managed with hormonal manipulation at time of local relapse and subsequently received external beam radiotherapy with or without hyperthermia. The hyperthermia was non-invasively induced using an annular phased array radiative electromagnetic system. Treatment was well tolerated, and none of the patients experienced severe rectal or bladder complications. Three patients are free from disease; one patient experience local-regional recurrence based on biopsy; one recurred in the bladder, was treated with cystoprostatectomy and subsequently succumbed to metastatic disease; and one patient died of presumed metastatic disease. External-beam irradiation with concurrent hyperthermia can be safely delivered to treat locally recurrent prostatic carcinoma after 125-iodine implantation

  20. Fractionated external beam radiotherapy of skull base metastases with cranial nerve involvement

    Droege, L.H.; Hinsche, T.; Hess, C.F.; Wolff, H.A. [University Hospital of Goettingen, Department of Radiotherapy and Radiation Oncology, Goettingen (Germany); Canis, M. [University of Goettingen, Department of Otorhinolaryngology, Head and Neck Surgery, Goettingen (Germany); Alt-Epping, B. [University of Goettingen, Department of Palliative Medicine, Goettingen (Germany)

    2014-02-15

    Skull base metastases frequently appear in a late stage of various tumor entities and cause pain and neurological disorders which strongly impair patient quality of life. This study retrospectively analyzed fractionated external beam radiotherapy (EBRT) as a palliative treatment approach with special respect to neurological outcome, feasibility and acute toxicity. A total of 30 patients with skull base metastases and cranial nerve disorders underwent EBRT with a mean total dose of 31.6 Gy. Neurological status was assessed before radiotherapy, during radiotherapy and 2 weeks afterwards categorizing orbital, parasellar, middle fossa, jugular foramen and occipital condyle involvement and associated clinical syndromes. Neurological outcome was scored as persistence of symptoms, partial response, good response and complete remission. Treatment-related toxicity and overall survival were assessed. Before EBRT 37 skull base involvement syndromes were determined with 4 patients showing more than 1 syndrome. Of the patients 81.1 % responded to radiotherapy with 10.8 % in complete remission, 48.6 % with good response and 21.6 % with partial response. Grade 1 toxicity of the skin occurred in two patients and grade 1 hematological toxicity in 1 patient under concurrent chemoradiotherapy. Median overall survival was 3.9 months with a median follow-up of 45 months. The use of EBRT for skull base metastases with symptomatic involvement of cranial nerves is marked by good therapeutic success in terms of neurological outcome, high feasibility and low toxicity rates. These findings underline EBRT as the standard therapeutic approach in the palliative setting. (orig.)

  1. Erectile function following brachytherapy, external beam radiotherapy, or radical prostatectomy in prostate cancer patients

    For localized prostate cancer, treatment options include external beam radiotherapy (EBRT), radical prostatectomy (RP), and brachytherapy (BT). Erectile dysfunction (ED) is a common side-effect. Our aim was to evaluate penile erectile function (EF) before and after BT, EBRT, or RP using a validated self-administered quality-of-life survey from a prospective registry. Analysis included 478 patients undergoing RP (n = 252), EBRT (n = 91), and BT (n = 135) with at least 1 year of follow-up and EF documented using IIEF-5 scores at baseline, 6 weeks, 6 months, 1 year, and annually thereafter. Differences among treatments were most pronounced among patients with no or mild initial ED (IIEF-5 ≥ 17). Overall, corrected for baseline EF and age, BT was associated with higher IIEF-5 scores than RP (+ 7.8 IIEF-5 score) or EBRT (+ 3.1 IIEF-5 score). EBRT was associated with better IIEF-5 scores than RP (+ 4.7 IIEF-5 score). In patients undergoing EBRT or RP with bilateral nerve sparing (NS), recovery of EF was observed and during follow-up, the differences to BT were not statistically significant. Overall age had a negative impact on EF preservation (corrected for baseline IIEF). In our series, EF was adversely affected by each treatment modality. Considered overall, BT provided the best EF preservation in comparison to EBRT or RP. (orig.)

  2. Multiobjective optimization with a modified simulated annealing algorithm for external beam radiotherapy treatment planning

    Inverse planning in external beam radiotherapy often requires a scalar objective function that incorporates importance factors to mimic the planner's preferences between conflicting objectives. Defining those importance factors is not straightforward, and frequently leads to an iterative process in which the importance factors become variables of the optimization problem. In order to avoid this drawback of inverse planning, optimization using algorithms more suited to multiobjective optimization, such as evolutionary algorithms, has been suggested. However, much inverse planning software, including one based on simulated annealing developed at our institution, does not include multiobjective-oriented algorithms. This work investigates the performance of a modified simulated annealing algorithm used to drive aperture-based intensity-modulated radiotherapy inverse planning software in a multiobjective optimization framework. For a few test cases involving gastric cancer patients, the use of this new algorithm leads to an increase in optimization speed of a little more than a factor of 2 over a conventional simulated annealing algorithm, while giving a close approximation of the solutions produced by a standard simulated annealing. A simple graphical user interface designed to facilitate the decision-making process that follows an optimization is also presented

  3. Erectile function following external beam radiotherapy for clinically organ-confined or locally advanced prostate cancer

    External beam radiotherapy (XRT) has been a standard treatment for clinically localized prostate cancer. However, preservation of erectile function following XRT is controversial. In this study, the influence of XRT on erectile function of patients with clinically organ-confined or locally advanced prostate cancer was retrospectively evaluated. The study included 34 of 84 patients with organ-confined or locally advanced prostate cancer who underwent XRT between 1995 and 2002. Erectile function following radiotherapy was assessed by a simple mailed questionnaire that was constructed for the study. To determine the predictive factors for erectile dysfunction following radiotherapy, data were analyzed by multivariate analysis with the Cox proportional hazards model. The modality of XRT was the only factor to independently predict erectile dysfunction following XRT. The maintenance rates of erectile function were 47.6% at 1 year and 19% at 3 years in patients who received the 3-dimensional conformal radiotherapy, which were significantly higher than in those who received conventional radiotherapy (P=0.026). XRT significantly reduced the maintenance rate of erectile function during the follow-up period, with the rate being 19% at 3 years in patients who received 3-dimensional conformal radiation. The XRT modality was involved in the reduction of erectile function. These results suggest that erectile dysfunction is a possible adverse event following XRT. (author)

  4. Optimising measles virus-guided radiovirotherapy with external beam radiotherapy and specific checkpoint kinase 1 inhibition

    Background and purpose: We previously reported a therapeutic strategy comprising replication-defective NIS-expressing adenovirus combined with radioiodide, external beam radiotherapy (EBRT) and DNA repair inhibition. We have now evaluated NIS-expressing oncolytic measles virus (MV-NIS) combined with NIS-guided radioiodide, EBRT and specific checkpoint kinase 1 (Chk1) inhibition in head and neck and colorectal models. Materials and methods: Anti-proliferative/cytotoxic effects of individual agents and their combinations were measured by MTS, clonogenic and Western analysis. Viral gene expression was measured by radioisotope uptake and replication by one-step growth curves. Potential synergistic interactions were tested in vitro by Bliss independence analysis and in in vivo therapeutic studies. Results: EBRT and MV-NIS were synergistic in vitro. Furthermore, EBRT increased NIS expression in infected cells. SAR-020106 was synergistic with EBRT, but also with MV-NIS in HN5 cells. MV-NIS mediated 131I-induced cytotoxicity in HN5 and HCT116 cells and, in the latter, this was enhanced by SAR-020106. In vivo studies confirmed that MV-NIS, EBRT and Chk1 inhibition were effective in HCT116 xenografts. The quadruplet regimen of MV-NIS, virally-directed 131I, EBRT and SAR-020106 had significant anti-tumour activity in HCT116 xenografts. Conclusion: This study strongly supports translational and clinical research on MV-NIS combined with radiation therapy and radiosensitising agents

  5. Variation in Use of Androgen Suppression With External-Beam Radiotherapy for Nonmetastatic Prostate Cancer

    Purpose: To describe practice patterns associated with androgen suppression (AS) stratified by disease risk group in patients undergoing external-beam radiotherapy (EBRT) for localized prostate cancer. Methods and Materials: We identified 2,184 low-risk, 2,339 intermediate-risk, and 2,897 high-risk patients undergoing EBRT for nonmetastatic prostate cancer diagnosed between January 1, 2004, and December 31, 2005, in the linked Surveillance, Epidemiology, and End Results—Medicare database. We examined the association of patient, clinical, and demographic characteristics with AS use by multivariate logistic regression. Results: The proportions of patients receiving AS for low-risk, intermediate-risk, and high-risk prostate cancer were 32.2%, 56.3%, and 81.5%, respectively. AS use among men in the low-risk disease category varied widely, ranging from 13.6% in Detroit to 47.8% in Kentucky. We observed a significant decline in AS use between 2004 and 2005 within all three disease risk categories. Men aged ≥75 years or with elevated comorbidity levels were more likely to receive AS. Conclusion: Our results identified apparent overuse and underuse of AS among men within the low-risk and high-risk disease categories, respectively. These results highlight the need for clinician and patient education regarding the appropriate use of AS. Practice patterns among intermediate-risk patients reflect the clinical heterogeneity of this population and underscore the need for better evidence to guide the treatment of these patients.

  6. PSA bounces after neoadjuvant androgen deprivation and external beam radiation: Impact on definitions of failure

    Purpose: To determine the characteristics of prostate specific antigen (PSA) bounces after external beam radiation therapy (EBRT) with neoadjuvant androgen deprivation and their impact on definitions of biochemical failure. Methods and Materials: Characteristics of bounce were calculated for all patients treated by EBRT with neoadjuvant androgen deprivation at our institution between 1992 and 1998 (preexclusion analysis). Calculations were repeated for the subgroup that satisfied additional inclusion/exclusion criteria (postexclusion analysis). The percentage of bounces scoring as false positives according to the ASTRO definition of biochemical failure was compared with those for three alternative definitions (Vancouver, Nadir-plus-two, and Nadir-plus-three) using McNemar's tests. Results: Thirty-nine percent (preexclusion cohort) and 56% (postexclusion cohort) of patients demonstrated a PSA bounce. Twenty percent (preexclusion analysis) and 25% (postexclusion analysis) of these bounces scored as biochemical failure according to the ASTRO definition. The Nadir-plus-three definition scored the smallest percentage of bounces as failure, but the difference between this definition and the ASTRO definition reached statistical significance in neither preexclusion nor postexclusion analyses (p ≥ 0.070). Conclusions: A substantial proportion of patients treated by EBRT with neoadjuvant deprivation experienced a PSA bounce. A large percentage of these bounces scored as biochemical failure according to the ASTRO definition. The Nadir-plus-three definition is less vulnerable to this bias

  7. Fractionated external beam radiotherapy of skull base metastases with cranial nerve involvement

    Skull base metastases frequently appear in a late stage of various tumor entities and cause pain and neurological disorders which strongly impair patient quality of life. This study retrospectively analyzed fractionated external beam radiotherapy (EBRT) as a palliative treatment approach with special respect to neurological outcome, feasibility and acute toxicity. A total of 30 patients with skull base metastases and cranial nerve disorders underwent EBRT with a mean total dose of 31.6 Gy. Neurological status was assessed before radiotherapy, during radiotherapy and 2 weeks afterwards categorizing orbital, parasellar, middle fossa, jugular foramen and occipital condyle involvement and associated clinical syndromes. Neurological outcome was scored as persistence of symptoms, partial response, good response and complete remission. Treatment-related toxicity and overall survival were assessed. Before EBRT 37 skull base involvement syndromes were determined with 4 patients showing more than 1 syndrome. Of the patients 81.1 % responded to radiotherapy with 10.8 % in complete remission, 48.6 % with good response and 21.6 % with partial response. Grade 1 toxicity of the skin occurred in two patients and grade 1 hematological toxicity in 1 patient under concurrent chemoradiotherapy. Median overall survival was 3.9 months with a median follow-up of 45 months. The use of EBRT for skull base metastases with symptomatic involvement of cranial nerves is marked by good therapeutic success in terms of neurological outcome, high feasibility and low toxicity rates. These findings underline EBRT as the standard therapeutic approach in the palliative setting. (orig.)

  8. Palliative external-beam radiotherapy for bone metastases from hepatocellular carcinoma

    Shinya; Hayashi; Hidekazu; Tanaka; Hiroaki; Hoshi

    2014-01-01

    The incidence of bone metastases(BMs)from hepatocellular carcinoma(HCC)is relatively low compared to those of other cancers,but it has increased recently,especially in Asian countries.Typically,BMs from HCC appear radiologically as osteolytic,destructive,and expansive components with large,bulky soft-tissue masses.These soft-tissue masses are unique to bone metastases from HCC and often replace the normal bone matrix and exhibit expansive growth.They often compress the peripheral nerves,spinal cord,or cranial nerves,causing not only bone pain but also neuropathic pain and neurological symptoms.In patients with spinal BMs,the consequent metastatic spinal cord compression(MSCC)causes paralysis.Skull base metastases(SBMs)with cranial nerve involvement can cause neurological symptoms.Therefore,patients with bony lesions often suffer from pain or neurological symptoms that have a severe,adverse effect on the quality of life.External-beam radiotherapy(EBRT)can effectively relieve bone pain and neurological symptoms caused by BMs.However,EBRT is not yet widely used for the palliative management of BMs from HCC because of the limited number of relevant studies.Furthermore,the optimal dosing schedule remains unclear,despite clinical evidence to support single-fraction ra-diation schedules for primary cancers.In this review,we outline data describing palliative EBRT for BMs from HCC in the context of(1)bone pain;(2)MSCC;and(3)SBMs.

  9. High-dose external beam irradiation inhibits neointima formation in stented pig coronary arteries

    Purpose: To evaluate high-dose external beam irradiation (EBRT) in a pig coronary stent preparation because low and intermediate-dose EBRT failed to show inhibition of neointima formation in stented animal models. Methods and Materials: Thirty-five stents were implanted in the coronary arteries of 17 pigs. Seven pigs were exposed to a single dose of 21 Gy EBRT immediately after stenting. Ten stented, nonirradiated pigs served as controls. After 4 weeks, the study arteries and myocardium were examined by light and scanning electron microscopy. Results: Compared with controls, 21 Gy EBRT resulted in a larger lumen area (7.57±1.67 mm2 vs. 4.00±1.63 mm2, p2 vs. 3.36±2.26 mm2, p<0.001) and a smaller maximal intimal thickness (0.16±0.09 mm vs. 0.68±0.31 mm, p<0.001). Unresorbed intramural hemorrhages and adherent mural thrombi were present in the irradiated vessels, which also showed incomplete re-endothelialization. The irradiated hearts demonstrated diffuse interstitial and perivascular inflammation and fibrosis. Conclusions: EBRT at 21 Gy to the entire heart significantly inhibited neointima formation in stented pig coronary arteries but also resulted in incomplete re-endothelialization, myocardial inflammation, and fibrosis. Improvements in localization and delivery techniques are required to allow clinical implementation of this technique

  10. Time of Decline in Sexual Function After External Beam Radiotherapy for Prostate Cancer

    Purpose: Erectile dysfunction is one of the most concerning toxicities for patients in the treatment of prostate cancer. The inconsistent evaluation of sexual function (SF) and limited follow-up data have necessitated additional study to clarify the rate and timing of erectile dysfunction after external beam radiotherapy (EBRT) for prostate cancer. Methods and Materials: A total of 143 men completed baseline data on SF before treatment and at the subsequent follow-up visits. A total of 1187 validated SF inventories were analyzed from the study participants. Multiple domains of SF (sex drive, erectile function, ejaculatory function, and overall satisfaction) were analyzed for ≤8 years of follow-up. Results: The median follow-up was 4.03 years. The strongest predictor of SF after EBRT was SF before treatment. For all domains of SF, the only statistically significant decrease in function occurred in the first 24 months after EBRT. SF stabilized 2 years after treatment completion, with no statistically significant change in any area of SF >2 years after the end of EBRT. Conclusion: These data suggest that SF does not have a continuous decline after EBRT. Instead, SF decreases maximally within the first 24 months after EBRT, with no significant changes thereafter.

  11. Reducing the risk of radiocarcinogenesis in paediatric patients treated with external beam radiotherapy

    Full text: The aim of this study was to determine readily-implementable means of out-of-field dose reduction in paediatric patients undergoing external beam radiotherapy for intracranial lesions. [n this way, the risk of secondary cancer induction may be reduced. Dose measurements were taken using LiF:Mg, Cu, P TLD100H chips in a 5 year old paediatric phantom. Multiple TLDs were placed at: the right and left lenses of the eye, optic nerve, brain, thyroid, lungs, heart, kidneys, abdomen and gonads. Varian 600C and Varian Trilogy linear accelerators, both at 6 MV, were investigated, using different delivery parameters. Most of the out-of-field dose at large distances is attributable to leakage. The difference between stereotactic and larger field sizes is less significant far from the primary field. Out-of-field dose from the Trilogy was 40% higher than the 600e. Aligning the craniocaudal axis of the patient with the x-plane of the collimator results in a dose reduction of 40%, for both machines. - A simple shielding arrangement may halve out-of-field dose. (author)

  12. Shear Behaviour of RC T-Beams with Externally Bonded Discrete CFF Strips – A Experimental and Finite Element Study

    Jayaprakash Jaganathan

    2014-10-01

    Full Text Available The application of fibre reinforced polymer (FRP composites for retrofitting and strengthening of existing reinforced concrete (RC structures has fascinated the attention of researchers and engineers in the recent decades.  This paper presents the results of experimental and finite element (FE investigation of shear behaviour of reinforced concrete T-beams repaired with externally bonded bi-directional discrete carbon fibre fabric (CFF strips.  The reinforced concrete T-beams were tested under four point bending system to investigate the performance of CFF shear strengthening scheme in terms of ultimate load carrying capacity.  These beams were modelled using LUSAS software.  To evaluate the behaviour of the simulated models, the predicted results were compared with the experimental results.  The experimental results show that the gain in shear capacity of the CFF repaired beams ranged between 20% and 40% over the control beam.  Thus, it can be concluded that the externally bonded CFF strips significantly increased the shear capacity of CFF repaired beams.  It was generally observed that the developed FE model shows better agreement with the experimental results.  The results of load-deflection profile, cracking pattern, modes of failure, and strain distribution in discrete CFF strips are presented.

  13. Endometrial cancer - reduce to the minimum. A new paradigm for adjuvant treatments?

    Up to now, the role of adjuvant radiation therapy and the extent of lymph node dissection for early stage endometrial cancer are controversial. In order to clarify the current position of the given adjuvant treatment options, a systematic review was performed. Both, Pubmed and ISI Web of Knowledge database were searched using the following keywords and MESH headings: 'Endometrial cancer', 'Endometrial Neoplasms', 'Endometrial Neoplasms/radiotherapy', 'External beam radiation therapy', 'Brachytherapy' and adequate combinations. Recent data from randomized trials indicate that external beam radiation therapy - particularly in combination with extended lymph node dissection - or radical lymph node dissection increases toxicity without any improvement of overall survival rates. Thus, reduced surgical aggressiveness and limitation of radiotherapy to vaginal-vault-brachytherapy only is sufficient for most cases of early stage endometrial cancer

  14. Long-term biochemical results after high-dose-rate intensity modulated brachytherapy with external beam radiotherapy for high risk prostate cancer

    Biochemical control from series in which radical prostatectomy is performed for patients with unfavorable prostate cancer and/or low dose external beam radiation therapy are given remains suboptimal. The treatment regimen of HDR brachytherapy and external beam radiotherapy is a safe and very effective treatment for patients with high risk localized prostate cancer with excellent biochemical control and low toxicity

  15. The new external microbeam facility at the 5 MV Tandetron accelerator laboratory in Madrid: beam characterisation and first results

    Enguita, Olga E-mail: olga.enguita@uam.es; Fernandez-Jimenez, M.T.; Garcia, G.; Climent-Font, A.; Calderon, T.; Grime, G.W

    2004-06-01

    This paper describes the new external microbeam on the 15 deg. beamline of the 5 MV Tandetron accelerator recently installed at the CMAM in Madrid. The focusing and beam extraction system was supplied by Oxford Microbeams Ltd. and consists of a high precision quadrupole doublet with an interchangeable Kapton window exit nozzle and front-viewing video microscope. The sample is positioned in the beam using a stepper motor stage. The beam current and beam profile have been determined under different experimental conditions. A simple method based on the signal processing of ion-induced luminescence from quartz targets has been used to determine the beam profile in two dimensions simultaneously, without scanning. This is the first step in the development of a real time beam profile monitoring system, which could be used as part of an automated beam focusing procedure. The beam line will be primarily devoted to archaeometry and cultural heritage studies. As an example we report the characterisation of two Tang appearance antique porcelains.

  16. The new external microbeam facility at the 5 MV Tandetron accelerator laboratory in Madrid: beam characterisation and first results

    This paper describes the new external microbeam on the 15 deg. beamline of the 5 MV Tandetron accelerator recently installed at the CMAM in Madrid. The focusing and beam extraction system was supplied by Oxford Microbeams Ltd. and consists of a high precision quadrupole doublet with an interchangeable Kapton window exit nozzle and front-viewing video microscope. The sample is positioned in the beam using a stepper motor stage. The beam current and beam profile have been determined under different experimental conditions. A simple method based on the signal processing of ion-induced luminescence from quartz targets has been used to determine the beam profile in two dimensions simultaneously, without scanning. This is the first step in the development of a real time beam profile monitoring system, which could be used as part of an automated beam focusing procedure. The beam line will be primarily devoted to archaeometry and cultural heritage studies. As an example we report the characterisation of two Tang appearance antique porcelains

  17. External beam radiation attenuates venous neointimal hyperplasia in a pig model of arteriovenous polytetrafluoroethylene (PTFE) graft stenosis

    Purpose: Hemodialysis vascular access dysfunction is an enormous clinical problem that causes great morbidity and costs well over one billion dollars per annum. The vast majority of hemodialysis vascular access dysfunction occurs as a result of venous stenosis and thrombosis at the graft-vein anastomosis. At a cellular level, this venous stenosis is the result of venous neointimal hyperplasia (VNH). There are, unfortunately, no effective therapies for VNH. The purpose of this study was to assess the role of external radiation therapy in preventing VNH and venous stenosis. Methods and Materials: Seven-centimeter polytetrafluoroethylene loop grafts were placed bilaterally between the femoral artery and vein of 12 Yorkshire Cross pigs. One side was treated with a single 16-Gy dose of external beam radiation with a linear accelerator, while the contralateral side served as an internal control. Swine were killed after 28 days, and the grafts were carefully dissected out and removed. Neointimal hyperplasia and luminal stenosis were then assessed morphometrically at the graft-vessel anastomoses. Results: External beam radiation therapy significantly reduced the amount of luminal stenosis at the graft-vein anastomosis, with minimal local and systemic toxicity. Conclusions: External beam radiation therapy could be a useful and clinically relevant local treatment for venous stenosis in polytetrafluoroethylene dialysis grafts

  18. Optical-fiber guided Al2O3:C radioluminescence dosimetry for external beam radiotherapy

    Small luminescence point-detectors coupled to optical-fiber cables (typically 1 mm diameter and 15 m length) may be used for medical dosimetry. Currently, the main luminescence materials are Al2O3:C and organic scintillator materials. The potential applications include, for example, online in vivo dose verification during remotely afterloaded brachytherapy, in vivo time-resolved IMRT dosimetry and dose-per-pulse measurements in megavolt x-ray beams. In the present work, we specifically explored the use of a new readout protocol for Al2O3:C for accelerator characterization measurements, and eventually, small-field dosimetry in external beam radiotherapy. Al2O3:C can in principle be used for radioluminescence (RL) dosimetry as well as optically stimulated luminescence (OSL) dosimetry. In the new readout protocol, however, we have eliminated the OSL readout. The main advantage of this so-called saturated RL protocol compared with the combined RL/OSL readout protocol is that it provides an RL sensitivity which is almost constant. Furthermore, the new readout protocol is much simpler and faster to use in the clinic. In contract to the main organic scintillators, it is noteworthy that the RL signal from Al2O3:C has a long luminescence life-time which allows for almost complete removal of any interference from light generated in the optical fiber cable due to stray radiation from pulsed beams. Measurements were conducted in a 6 MV beam (Varian iX linear accelerator, USA) using a solid- water phantom (type 457, Gammex, USA) and a 2 mg Al2O3:C crystal (Landauer Inc, USA) attached to a PMMA optical-fiber cable. The data acquisition system recorded both the RL signal from the Al2O3:C and the number of accelerator gun pulses (deduced from the so-called target current signal). The new RL-protocol with saturated Al2O3:C was found to be highly sensitive (-5x106 counts pr. Gy) and doses in the range from 10 mGy to above 15 Gy could be measured using a single calibration factor

  19. Investigation of the Chaotic Dynamics of an Electron Beam with a Virtual Cathode in an External Magnetic Field

    Egorov, E N

    2006-01-01

    The effect of the strength of the focusing magnetic field on chaotic dynamic processes occurring inan electron beam with a virtual cathode, as well as on the processes whereby the structures form in the beamand interact with each other, is studied by means of two-dimensional numerical simulations based on solving a self-consistent set of Vlasov-Maxwell equations. It is shown that, as the focusing magnetic field is decreased,the dynamics of an electron beam with a virtual cathode becomes more complicated due to the formation andinteraction of spatio-temporal longitudinal and transverse structures in the interaction region of a vircator. The optimum efficiency of the interaction of an electron beam with the electromagnetic field of the vircator isachieved at a comparatively weak external magnetic field and is determined by the fundamentally two-dimensional nature of the motion of the beam electrons near the virtual cathode.

  20. Development of silicon monolithic arrays for dosimetry in external beam radiotherapy

    Bisello, Francesca, E-mail: francesca.bisello@iba-group.com [IBA Dosimetry GmbH, Schwarzenbruck (Germany); Friedrich-Alexander Universität Erlangen—Nürnberg, Erlangen (Germany); Menichelli, David [IBA Dosimetry GmbH, Schwarzenbruck (Germany); Scaringella, Monica [University of Florence, Firenze (Italy); INFN—Florence Division, Sesto Fiorentino (Italy); Talamonti, Cinzia; Zani, Margherita; Bucciolini, Marta [University of Florence, Firenze (Italy); Azienda Ospedaliera Unversitaria Careggi, Firenze (Italy); Bruzzi, Mara [University of Florence, Firenze (Italy); INFN—Florence Division, Sesto Fiorentino (Italy)

    2015-10-01

    New tools for dosimetry in external beam radiotherapy have been developed during last years in the framework of the collaboration among the University of Florence, INFN Florence and IBA Dosimetry. The first step (in 2007) was the introduction in dosimetry of detector solutions adopted from high energy physics, namely epitaxial silicon as the base detector material and a guard ring in diode design. This allowed obtaining state of the art radiation hardness, in terms of sensitivity dependence on accumulated dose, with sensor geometry particularly suitable for the production of monolithic arrays with modular design. Following this study, a 2D monolithic array has been developed, based on 6.3×6.3 cm{sup 2} modules with 3 mm pixel pitch. This prototype has been widely investigated and turned out to be a promising tool to measure dose distributions of small and IMRT fields. A further linear array prototype has been recently design with improve spatial resolution (1 mm pitch) and radiation hardness. This 24 cm long device is constituted by 4×64 mm long modules. It features low sensitivity changes with dose (0.2%/kGy) and dose per pulse (±1% in the range 0.1–2.3 mGy/pulse, covering applications with flattened and unflattened photon fields). The detector has been tested with very satisfactory results as a tool for quality assurance of linear accelerators, with special regards to small fields, and proton pencil beams. In this contribution, the characterization of the linear array with unflattened MV X-rays, {sup 60}Co radiation and 226 MeV protons is reported. - Highlights: • A silicon monolithic 1D array with 1 mm pixel pitch was developed. • The detector was characterized with {sup 60}Co, unflattened MV X-rays, 226 MeV protons. • Dose linearity in clinical relevance range and dose profiles were measured. • The detector performs good agreement with reference detectors. • The technology is suitable in dose profiling in MV X-ray and proton therapy.

  1. A simple technique for treating age-related macular degeneration with external beam radiotherapy

    Purpose: To develop a simple external beam photon radiotherapy technique to treat age-related macular degeneration without the need for simulation, planning computed tomography (CT) or computer dosimetry. Methods and Materials: The goal was to enable the treatment to be set up reliably on the treatment machine on Day 1 with the patient supine in a head cast without any prior planning. Using measurements of ocular globe topography from Karlsson et al. (Int J Radiat Oncol Biol Phys 1996; 33: 705-712), we chose a point 1.5 cm behind the anterior surface of the upper eyelid (ASUE) as the isocentre of a half-beam, blocked, 5.0 x 3.0-cm, angled lateral field to treat the involved eye. This would position the isocentre about 0.5 cm behind the posterior surface of the lens, and a little over 1 cm in front of the macula, according to Karlsson et al. The setup requires initial adjustment of the gantry from horizontal (to account for any asymmetry of position of the eyes), then angling 15 deg. posteriorly to avoid the contralateral eye. Finally, the couch is raised to position the isocentre 1.5 cm behind the ASUE. Results: To verify the applicability of the technique, we performed CT and computer dosimetry on the first 11 eyes so treated. Our CT measurements were in good agreement with Karlsson et al. The lens dose was < 5% and the macula was within the 95% isodose curve in each case (6-MV linac). Treatment setup time is approximately 10 min each day. The 11 patients were treated with 5 x 2.00 Gy (2 patients) or 5 x 3.00 Gy (9 patients), and subjective response on follow-up over 1 to 12 months (median 4 months) was comparable to previously reported results, with no significant acute side effects. Conclusion: Our technique is easy to set up and reliably treats the macula, with sparing of the lens and contralateral eye. It enables treatment to commence rapidly and cost-effectively without the need for simulation or CT computer planning

  2. Assessment of the effect of beam modifiers on skin dose for external beam radiotherapy using Gafchromic EBT2 film

    The purpose of this study was to assess the effect of different beam modifiers on the skin dose for 60Co and 15 MV photon beams. Skin doses were measured for solid water (PMMA) phantoms with Gafchromic films. It was observed that, skin dose for all the beam modifiers as well as that for the open beams increases as field size increases. At SSD of 80 cm, skin doses for 10 x 10 cm2 and 25 x 25 cm2 were, 36.9%, and 61.8% respectively for the 60Co unit. It was observed that, for a particular field size, skin dose for the 15 MV photon beam was much lower than that for 60Co beam, which gives an advantage of using the 15 MV photon beam over 60Co beam. As SSD increases skin dose reduces for both 60Co and 15 MV photon beams. For wedged fields (with 600 motorized wedge, it was found that there were very little effects on skin dose for smaller fields but significant effects for the larger fields (≥15 x 15 cm2) as compared with open beams for the 15 MV photon beam. Skin dose for bolus was higher compared with that of open beam and were 57.4% and 73.8% for 10 x 10 cm2 and 20 x 20 cm2 at 100 cm SSD respectively. For 60Co beam, the physical wedges and the 1.5 cm thickness compensator greatly reduced skin doses as compared to all the other beam modifiers. The skin doses for 10 × 10 cm2 field were 21.3%, 19.4%, 18.7%, 19.1% and 23.6% for 150, 300, 450, 600 and the 1.5 cm thickness compensators respectively, at SSD of 80 cm). These compared with 35.4% and 33.7% for the tray and open fields at the same SSD and field size as those for the wedges and compensator above. Skin doses reduced as the compensator thickness was increased. (au)

  3. Combined external-beam PIXE and {mu}-Raman characterisation of garnets used in Merovingian jewellery

    Calligaro, T. E-mail: thomas.calligaro@culture.gouv.fr; Colinart, S.; Poirot, J.-P.; Sudres, C

    2002-04-01

    Red garnets were the dominant gemstones used for jewels in Europe during the Early Middle Ages. We have studied over 350 garnets set on 12 jewels unearthed in the royal necropolis of the Saint-Denis Basilica, close to Paris. This famous collection of 'cloisonne' style artefacts dates from the Merovingian period (late fifth century AD to early seventh century AD). The archaeological issue addressed is the identification of the geographical origin of these garnets, in view to establish the gem trading routes during the Dark Ages. External beam PIXE was used to determine the major constituents (Mg, Al, Si, Ca, Mn, Fe), specifying the garnet type (composition in various mineralogical end-members, e.g. almandine, pyrope, spessartite, ...), and the trace element content (Cr, Y). Three sorts of garnets were identified. Ten jewels are adorned with almandine garnets (Fe-rich). One jewel has intermediate almandine-pyrope garnets ('rhodolite'). The last and most recent jewel is inlaid with pyrope (Mg-rich) garnets. Trace element content and slight differences in major composition allowed to distinguish five different sources: two sources for pyrope garnets (with and without chromium), and two sources for almandine garnets (distinctive calcium, magnesium and yttrium contents). A preliminary comparison with literature data suggested that almandine garnets may have been mined from India while the 'rhodolite' garnets may have been imported from Sri Lanka. The sources of pyrope garnets could be the Bohemian deposits (Czech republic). In addition, {mu}-Raman spectrometry was used to identify most of the mineral inclusions (apatite, zircon, ilmenite, monazite, calcite, quartz) present in almandine garnets. Even if two specific types of inclusions were not identified, due to the lack of corresponding reference spectra in our database, the Raman spectra collected provided an interesting inclusion fingerprint.

  4. Combined external-beam PIXE and μ-Raman characterisation of garnets used in Merovingian jewellery

    Red garnets were the dominant gemstones used for jewels in Europe during the Early Middle Ages. We have studied over 350 garnets set on 12 jewels unearthed in the royal necropolis of the Saint-Denis Basilica, close to Paris. This famous collection of 'cloisonne' style artefacts dates from the Merovingian period (late fifth century AD to early seventh century AD). The archaeological issue addressed is the identification of the geographical origin of these garnets, in view to establish the gem trading routes during the Dark Ages. External beam PIXE was used to determine the major constituents (Mg, Al, Si, Ca, Mn, Fe), specifying the garnet type (composition in various mineralogical end-members, e.g. almandine, pyrope, spessartite, ...), and the trace element content (Cr, Y). Three sorts of garnets were identified. Ten jewels are adorned with almandine garnets (Fe-rich). One jewel has intermediate almandine-pyrope garnets ('rhodolite'). The last and most recent jewel is inlaid with pyrope (Mg-rich) garnets. Trace element content and slight differences in major composition allowed to distinguish five different sources: two sources for pyrope garnets (with and without chromium), and two sources for almandine garnets (distinctive calcium, magnesium and yttrium contents). A preliminary comparison with literature data suggested that almandine garnets may have been mined from India while the 'rhodolite' garnets may have been imported from Sri Lanka. The sources of pyrope garnets could be the Bohemian deposits (Czech republic). In addition, μ-Raman spectrometry was used to identify most of the mineral inclusions (apatite, zircon, ilmenite, monazite, calcite, quartz) present in almandine garnets. Even if two specific types of inclusions were not identified, due to the lack of corresponding reference spectra in our database, the Raman spectra collected provided an interesting inclusion fingerprint

  5. Combined external-beam PIXE and /μ-Raman characterisation of garnets used in Merovingian jewellery

    Calligaro, T.; Colinart, S.; Poirot, J.-P.; Sudres, C.

    2002-04-01

    Red garnets were the dominant gemstones used for jewels in Europe during the Early Middle Ages. We have studied over 350 garnets set on 12 jewels unearthed in the royal necropolis of the Saint-Denis Basilica, close to Paris. This famous collection of "cloisonné" style artefacts dates from the Merovingian period (late fifth century AD to early seventh century AD). The archaeological issue addressed is the identification of the geographical origin of these garnets, in view to establish the gem trading routes during the Dark Ages. External beam PIXE was used to determine the major constituents (Mg, Al, Si, Ca, Mn, Fe), specifying the garnet type (composition in various mineralogical end-members, e.g. almandine, pyrope, spessartite, …), and the trace element content (Cr, Y). Three sorts of garnets were identified. Ten jewels are adorned with almandine garnets (Fe-rich). One jewel has intermediate almandine-pyrope garnets ("rhodolite"). The last and most recent jewel is inlaid with pyrope (Mg-rich) garnets. Trace element content and slight differences in major composition allowed to distinguish five different sources: two sources for pyrope garnets (with and without chromium), and two sources for almandine garnets (distinctive calcium, magnesium and yttrium contents). A preliminary comparison with literature data suggested that almandine garnets may have been mined from India while the "rhodolite" garnets may have been imported from Sri Lanka. The sources of pyrope garnets could be the Bohemian deposits (Czech republic). In addition, μ-Raman spectrometry was used to identify most of the mineral inclusions (apatite, zircon, ilmenite, monazite, calcite, quartz) present in almandine garnets. Even if two specific types of inclusions were not identified, due to the lack of corresponding reference spectra in our database, the Raman spectra collected provided an interesting inclusion fingerprint.

  6. Comparative Study of Inguinal Hernia Repair Rates After Radical Prostatectomy or External Beam Radiotherapy

    Purpose: We tested the hypothesis that patients treated for localized prostate cancer with radical prostatectomy (RP) have a higher risk of requiring an inguinal hernia (IH) repair than their counterparts treated with external beam radiotherapy (EBRT). Methods and Materials: Within the Quebec Health Plan database, we identified 6,422 men treated with RP and 4,685 men treated with EBRT for localized prostate cancer between 1990 and 2000, in addition to 6,933 control patients who underwent a prostate biopsy. From among that population, we identified patients who underwent a unilateral or bilateral hernia repair after either RP or EBRT. Kaplan-Meier plots showed IH repair-free survival rates. Univariable and multivariable Cox regression models tested the predictors of IH repair after RP or EBRT. Covariates consisted of age, year of surgery, and Charlson Comorbidity Index. Results: IH repair-free survival rates at 1, 2, 5, and 10 years were 96.8, 94.3, 90.5, and 86.2% vs. 98.9, 98.0, 95.4, and 92.2%, respectively, in RP vs. EBRT patients (log-rank test, p < 0.001). IH repair-free survival rates in the biopsy population were 98.3, 97.1, 94.9, and 90.2% at the same four time points. In multivariable Cox regression models, RP predisposed to a 2.3-fold higher risk of IH repair than EBRT (p < 0.001). Besides therapy type, patient age (p < 0.001) represented the only other independent predictor of IH repair. Conclusions: RP predisposes to a higher rate of IH repair relative to EBRT. This observation should be considered at informed consent.

  7. Increasing Use of Dose-Escalated External Beam Radiation Therapy for Men With Nonmetastatic Prostate Cancer

    Purpose: To examine recent practice patterns, using a large national cancer registry, to understand the extent to which dose-escalated external beam radiation therapy (EBRT) has been incorporated into routine clinical practice for men with prostate cancer. Methods and Materials: We conducted a retrospective observational cohort study using the National Cancer Data Base, a nationwide oncology outcomes database in the United States. We identified 98,755 men diagnosed with nonmetastatic prostate cancer between 2006 and 2011 who received definitive EBRT and classified patients into National Comprehensive Cancer Network (NCCN) risk groups. We defined dose-escalated EBRT as total prescribed dose of ≥75.6 Gy. Using multivariable logistic regression, we examined the association of patient, clinical, and demographic characteristics with the use of dose-escalated EBRT. Results: Overall, 81.6% of men received dose-escalated EBRT during the study period. The use of dose-escalated EBRT did not vary substantially by NCCN risk group. Use of dose-escalated EBRT increased from 70.7% of patients receiving treatment in 2006 to 89.8% of patients receiving treatment in 2011. On multivariable analysis, year of diagnosis and use of intensity modulated radiation therapy were significantly associated with receipt of dose-escalated EBRT. Conclusions: Our study results indicate that dose-escalated EBRT has been widely adopted by radiation oncologists treating prostate cancer in the United States. The proportion of patients receiving dose-escalated EBRT increased nearly 20% between 2006 and 2011. We observed high utilization rates of dose-escalated EBRT within all disease risk groups. Adoption of intensity modulated radiation therapy was strongly associated with use of dose-escalated treatment

  8. MRI of the prostate after combined radiotherapy (interstitial with external beam irradiation): histopathological correlation

    Aim: To identify the MRI changes of the prostate after combined (high-dose rate interstitial with external beam) radiotherapy for, localized prostate cancer and to correlate the findings with histology in order to determine the value of MR imaging in the follow-up of these patients. Material and methods: Twenty-three patients underwent MR imaging at 1.5 T between 6 and 24 months after completion of combined radiotherapy. The prostate was imaged with axial and coronal T2-weighted sequences and axial T1-weighted sequences before and after intravenous administration of Gd-DTPA. Quandrant or sextant biopsy was performed in all cases and three patients with proven persistence of the tumor underwent salvage prostatectomy. The MRI findings were compared with the biopsy results or the large-area sections. Results: On T2-weighted images the fibrotically changed peripheral zone was hypointense while persistent tumor tissue showed hyperintensity. Solid tumors were depicted when they had a diameter of 1 cm or more. Persistent tumors of the diffuse multifocal type escaped detection. Contrast-enhanced T1-weighted imaging yielded no additional information. The accuracy in detecting persistent tumor was 74%. Conclusions: Histopathologic changes seen after combined radiotherapy correlate with the findings on T2-weighted MR images. MR imaging cannot replace follow-up by routine biopsy. Its only role is assessing local operability in cases found to have increasing PSA levels during follow-up. Further studies are needed to determine the role of MR imaging in this patient population. (orig.)

  9. Can external beam irradiation to the neck prevent later regional relapse of stage II tongue cancer?

    A multi-institutional retrospective questionnaire surver was done, to evaluate the efficacy of elective neck irradiation with a dose of around 30 Gy/3 weeks, to prevent later regional relapse of stage II tongue cancer. Six hundred fifty-one patients treated with brachytherapy (BT) from 1980 to 1994 were evaluated. Event free survivors whose follow-up periods were less than 2 years were excluded from the analysis. There were 454 patients treated with BT only, and 197 with external beam irradiation (EBI)+BT. The median BT and EBI dose was 70 Gy and 30 Gy, respectively. Cause-specific survival (CSSR), local control (LCR), and regional relapse rates (RRR) were calculated by the Kaplan Meier method, and significance was tested by the Cox Mantel method. Late complications were evaluated by RTOG/EORTC criteria. The median follow-up period of survivors was 87 months. Fifty-four patients had only local relapse, 193 had only regional relapse, and 61 had both. CSSR, LCR, and RRR of patients treated with BT, and with EBI+BT, were 77%, 85%, and 43%, and 81%, 78%, and 33%, respectively. RRR of patients treated with EBI+BT was significantly lower than that of BT (p<0.01). There was no significance of CSSR, LCR, and late complications between BT and EBI+BT. RRR of the radiation field, including mid jugular nodes, was significantly lower than that of smaller field (p<0.0001). Elective neck irradiation significantly reduced later regional relapse without increasing late complications for Stage II tongue cancer patients. A radiation field including mid jugular nodes and an EBI dose of 30 Gy/3 weeks, were recommended for brachytherapy of Stage II tongue cancer. (author)

  10. External beam irradiation of craniopharyngiomas: long-term analysis of tumor control and morbidity

    Purpose: To delineate the long-term control and morbidity with external beam radiotherapy (EBRT) of craniopharyngiomas. Methods and Materials: Between 1971 and 1992, 24 craniopharyngioma patients underwent EBRT at the University of Pittsburgh. Most (19 of 24) were treated within 1-3 months after subtotal resection. The other prior surgical procedures were biopsy (n = 2) and gross total resection (n = 1); 2 patients did not undergo any surgical procedure. The median follow-up was 12.1 years. The median patient age was 29 years (range 5-69). The total radiation doses varied from 36 to 70 Gy (median 59.75). The normalized total dose (NTD, biologically equivalent dose given in 2 Gy/fraction [α/β ratio = 2]) varied from 28 to 83 Gy (median 55.35). Results: The actuarial survival rate at 10 and 20 years was 100% and 92.3%, respectively. The actuarial local control rate at 10 and 20 years was 89.1% and 54.0%, respectively. No local failures occurred with doses ≥60 Gy (n=12) or NTDs ≥55 Gy. The complication-free survival rate at 10 and 20 years was 80.1% and 72.1%, respectively. No complications were noted with an NTD of ≤55 Gy. The actuarial survival free from any adverse outcome (recurrence or complication) was 70.1% and 31.8% at 10 and 20 years, respectively. The adverse outcome-free survival appeared optimized (at 73%) with an NTD of 55-63 Gy. Multivariate analysis found that tumor control correlated significantly with the total dose (p=0.02), treatment complications with NTD (p=0.008), and adverse outcome with hypopituitarism on presentation (p=0.03). Conclusion: We recommend treating craniopharyngioma with 1.6-1.7-Gy dose fractions to 60 Gy to optimize outcome from EBRT